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Positive Psychology and Physical Health

Research and Applications

Nansook Park , PhD

Christopher peterson , phd, daniel szvarca , bs, randy j vander molen , ba, eric s kim , ms, kevin collon , ba.

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Nansook Park, PhD, Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109-1043; e-mail: [email protected] .

Received 2012 May 29; Revised 2014 Apr 15; Accepted 2014 May 7; Collection date 2016 May-Jun.

Positive psychology is the scientific study of a healthy and flourishing life. The goal of positive psychology is to complement and extend the traditional problem-focused psychology that has proliferated in recent decades. Positive psychology is concerned with positive psychological states (eg, happiness), positive psychological traits (eg, talents, interests, strengths of character), positive relationships, and positive institutions. We describe evidences of how topics of positive psychology apply to physical health. Research has shown that psychological health assets (eg, positive emotions, life satisfaction, optimism, life purpose, social support) are prospectively associated with good health measured in a variety of ways. Not yet known is whether positive psychology interventions improve physical health. Future directions for the application of positive psychology to health are discussed. We conclude that the application of positive psychology to health is promising, although much work remains to be done.

Keywords: positive psychology, health psychology, health, well-being, positive interventions

‘. . . a happy, engaged, and fulfilling psychological and social life is not just a consequence of good health, it is what leads people to live a healthy and long life.’

Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. —World Health Organization 1

Most would agree with this statement, but over the years, it has been largely a slogan. More recently, theory, research, and applications from the perspective of positive psychology have helped articulate the meaning of health and well-being. Positive psychology is an umbrella term for the scientific study of the various contributors to a healthy and thriving life for the self and others (eg, positive emotions, life meaning, engaging work, and close relationships). 2 It is the study of strengths, assets, and positive attributes. The topics of concern to positive psychology are broad indicators of psychological, social, and societal well-being.

Research has shown that not only are physical, mental, and social well-beings important components for complete health, but they are also interconnected. Evidence is accumulating that a happy, engaged, and fulfilling psychological and social life is not just a consequence of good health, it is what leads people to live a healthy and long life.

This article provides a brief overview of what positive psychology is and addresses how theories, findings, and especially applications from positive psychology might pertain to physical health.

What Is Positive Psychology?

Positive psychology is a perspective within psychology that studies optimal experience, people being and doing their best. 2 - 4 It challenges the assumptions of the disease model. Positive psychology assumes that life entails more than avoiding or undoing problems and that explanations of the good life must do more than reverse accounts of problems. Someone without symptoms or disorders may or may not be living well. Positive psychology urges attention to what is taking place on the other side of the zero point of being problem-free. It calls for as much focus on strength as on weakness, as much interest in building the best things in life as in repairing the worst, and as much attention to fulfilling the lives of healthy people as to healing the wounds of the distressed. Research findings from positive psychology are intended to contribute to a more complete and balanced scientific understanding of human experiences and ways to foster thriving in individuals, communities, and societies.

One of the triggers for the introduction of positive psychology was the realization that since World War II, psychology as a field had devoted much of its effort to identifying, treating, and—occasionally—preventing problems such as anxiety and depression. 3 The yield of these problem-focused efforts has been impressive, but a myopic view of the human condition has resulted. It is as if psychology has viewed people as only fragile and flawed.

The goal of positive psychology is to complement and extend the problem-focused psychology, and an important idea from positive psychology is that one way to solve problems is by identifying and leveraging individual and societal strengths and assets. 5

The topics of concern to positive psychology can be divided into 4 related topics 2 , 3 :

Positive subjective experiences (happiness, gratification, fulfillment, flow)

Positive individual traits (strengths of character, talents, interests, values)

Positive interpersonal relationships (friendship, marriage, colleagueship)

Positive institutions (families, schools, businesses, communities)

The value of positive psychology is to use the scientific method to sort through various claims and hypotheses about what it means to live well or poorly and to identify the relevant circumstances in each case.

Positive Psychology and Health

Can physical health be clarified by a positive perspective in the same way that psychological well-being has been clarified? To return to the definition of health by the World Health Organization with which this article began, 1 a positive perspective urges us to look beyond the mere absence of disease and infirmity to define what it means to be healthy in positive terms. 6 - 8 Positive health can be characterized not only as a long and disease-free life but additionally in terms of

Less frequent and briefer ailments

Greater recuperative ability

Rapid wound healing

More physiological reserves

Chronic but nondebilitating diseases

Familiar within the field of epidemiology are the population-level concepts of DALYs (disability adjusted life years), HALYs (health-adjusted life years), and QALYs (quality-adjusted life years), which combine measures of morbidity and mortality into the same index. 9 Along these lines, HLEs (happiness-adjusted life expectancies) measure the quality of life in a nation by forming the product of the average life expectancy and the average happiness (aka subjective well-being, life satisfaction) in that nation. 10 Positive health concerns itself with the individual-level analogues of these constructs.

The field of positive health as we envision it overlaps with allied approaches concerned with disease prevention, health promotion , and wellness. The value of positive health as an approach in its own right is that it makes explicit the need to consider good health as opposed to the absence of poor health. Studies of “wellness” often end up being studies of illness, much as studies of mental “health” are often studies of mental illness.

Concern with positive health leads to an examination of health assets , individual-level factors that produce positive health in one or more of the ways that it might be defined, over-and-above the frequently studied risk factors for poor health, like high cholesterol, obesity, smoking, excessive alcohol use, and a sedentary lifestyle. 8 Among the psychosocial risk factors frequently examined with respect to poor health are anger, anxiety, depression, and social isolation. By the logic of a positive perspective, the mere absence of these negative states and traits is not all that matters for physical health. Important as well are positive states and traits, and the contribution of these in their own right needs to be studied, controlling for negative states and traits as well as other usual-suspect risk factors.

There have been extensive studies on negative psychological factors such as stress, depression, hostility, and their effects on increased risk of various health problems. 11 However, less known is whether certain positive psychological factors play a protective role against health risks. Research has shown that positive and negative emotions are not opposite and are only modestly correlated. 12 , 13 Experiencing each of those emotions is also involved in the activation of different brain regions. 14

For the past several years, researchers have examined the contributions of health assets, especially psychological ones, to good health, while they have controlled for established risk factors. Researchers need to examine both risk factors and health assets to understand relationships between both positive and negative psychological factors as they together contribute to health outcomes.

Carefully conducted research shows that positive health assets indeed predict good health assessed in a variety of ways. 15 Among the positive psychology health assets foreshadowing good health are

Positive emotions 16 , 17

Life satisfaction 17 , 18

Optimism 19 - 22

Forgiveness 23

Self-regulation 24

Vitality and zest 25

Life meaning and purpose 26 - 29

Helping others and volunteering 30 - 32

Good social relationships 33 - 35

Spirituality and religiosity 36 , 37

There has been growing evidence that positive psychological characteristics affect health and longevity using various research methods including longitudinal prospective and experimental designs.

Perhaps, among the most well-known long-term studies that showed the possible link between positive psychological assets and health outcomes is The Nun Study. 38 A group of American nuns who were members of the School Sisters of Notre Dame wrote autobiographical essays in their early 20s when they joined the Sisterhood. Six decades later, researchers who had accessed the convent archive scored the emotional content of 180 essays in terms of positivity, and investigated whether they were related to the mortality of nuns. Indeed, positive emotional content was significantly related to longevity. The nuns who expressed more positive emotions (those in the upper 25%) in their essays, strikingly, lived on average 10 years longer than those expressing fewer positive emotions (those in the bottom 25%). In other words, happier nuns lived longer than less happy (but not depressed) nuns. Putting this in context, unhealthy behavior like smoking costs on average 7 years of one’s life. 2

In another experimental study, Cohen and his colleagues examined the relationships between positive emotions and the vulnerability of catching the common cold. 39 With 334 healthy adult volunteers in the community, they first measured both positive emotional experience, such as happy, pleased, lively, and relaxed, and negative emotional experiences, such as depressed, anxious, and hostile, over a few weeks using self-reports. Afterward, participants were invited to the study lab and exposed to rhinoviruses through nasal drops and monitored in quarantine for the development of the common cold. The researchers found that higher positive emotional experiences were related to lower risk of developing a cold and fewer reports of symptoms, while negative emotional experiences were not significantly related to catching a cold, but associated with reports of more symptoms. In short, this study showed that experiencing positive emotions was linked to greater resistance to developing the common cold.

The health benefits of positive psychological assets have been documented in different cultural settings as well. For instance, in Japanese culture, the most commonly used indicator of subjective well-being is the sense of “life worth living” ( ikigai ). 29 In a population-based prospective cohort study with 43, 391 adults in Ohsaki, Japan, lack of the sense of “life worth living” ( ikigai ) was significantly associated with higher risk of all-cause mortality over time. Those who reported having an ikigai in their life in a survey were more likely to be alive at a 7-year follow-up compared to their counterparts who did not find a sense of ikigai . Interestingly, the increase in mortality risk was due to an increase in mortality from cardiovascular disease and external causes such as suicide, but not to morality from cancer. Having a sense of “life worth living” ( ikigai ) often means having a purpose in life and realizing the value of being alive which could serve as a motivation for living.

In our own study with US adults, having life purpose played a protective role for heart health. 27 At a 2-year follow-up, the higher level of life purpose was prospectively related to lower risks of incidence of myocardial infarction among people with coronary heart disease at the baseline.

One of the ways to achieve a sense of life meaning and purpose is through helping others and doing regular volunteer work in communities. Research has shown that among elders, people who volunteer regularly are healthier and live longer. 30 , 31 In a longitudinal study with a nationally representative sample of community-dwelling older US adults, a study found that volunteerism predicted a lower risk of hypertension 4 years later. 31 That is, those who had volunteered at least 200 hours in the previous 12 months were less likely to develop hypertension risk compared to those who did not volunteer. However, lower levels of volunteering did not decrease the health risk of hypertension. It seems that dosage and intentions of volunteering matters for its health benefits. In another study, people who regularly volunteered for self-oriented motives did not exhibit lower risk for mortality 4 years later, while those who regularly and frequently volunteered for other-oriented motives showed lower risk of subsequent mortality. 32 In conclusion, it is good to be good!

One of the well-studied health-related positive psychology topics is optimism. Optimism is sometimes seen as pollyannaism, a naively rosy view of the world coupled with a “don’t worry, be happy” attitude. However, optimism the way researchers study it is a disposition to an expectation that the future will entail more positive events than negative ones. 40 Optimists are neither in denial nor naive about challenges and difficulties in life. They simply attend to and acknowledge the positive.

Empirical research shows that optimism—usually assessed with self-report surveys—relates to good health and a long life. According to research, among asymptomatic men with HIV, optimism slowed the onset of AIDS over an 18-month follow-up. 41 , 42 Over an 8-year follow-up, optimism predicted better pulmonary function among older men, even when smoking was controlled. 43 In a longitudinal study of older men and women, optimism predicted not only better health but also lower levels of pain. 44 Our own research group recently reported a study of a large nationally representative sample of older adults (aged >50 years) in the United States showing that over a 2-year period, optimism predicted a lower likelihood of stroke, even after controlling for chronic illnesses, self-rated health, and relevant sociodemographic, biological, and psychological factors. 45

In addition, the importance of social support and positive relationships on good health and well-being has long been documented. Supportive social relationships were associated with longevity, less cognitive decline with aging, greater resistance to infectious disease, and better management of chronic illnesses. 33 - 35

Enough well-designed studies exist in support of the premise that health assets predict good health to warrant further investigation. Research so far provides compelling evidence that positive psychological health assets predict or are associated with various health outcomes and longevity among healthy populations. However, what is relatively unknown are the effects of positive health assets for recovery and long-term health outcomes among those with serious health problems such as cancer.

Furthermore, before we consider interventions that deliberately encourage these assets in order to reduce morbidity and mortality and to increase physical well-being, there are issues that need to be addressed. 46

First, assuming that health assets do play a causal role, what are the mechanisms? Research to date has often been stark, usually demonstrating an association over time but not clarifying how it happens. We assume the pathways are multiple, from biological to emotional to cognitive to behavioral to social. For example, in the case of optimism, biologically, it has been linked to better immune system functioning, and behaviorally, people who are optimistic engage in healthier behaviors. They eat healthy, exercise, do not smoke or drink, and seek medical care when they need. Socially, optimists have better and more frequent social contacts. All of these are associated with health benefits.

It is unknown which pathway bears the most traffic or whether the mechanisms vary as a function of the specific health outcome (eg, cardiovascular disease vs the common cold) or as a function of the individual’s age, gender, or lifestyle. Again, the best a researcher can do is to identify plausible mechanisms in a given study and explicitly investigate their role as mediators.

Second, are health assets a cause of good health or merely a correlated marker of its real causes? Indeed, the array of positive health assets is challenging for researchers, who cannot study or control all possible assets in the same investigation. No single study relying on correlational data can be definitive, so it is the overall body of research investigating health assets that must be examined to draw causal conclusions. 17

Third, do the apparent benefits of health assets generalize to all kinds of health outcomes? Much of the relevant research has ascertained general health and all-cause mortality, and some of this work has relied only on self-reported information about health status. When researchers look at specific health outcomes assessed in more objective ways, psychological health assets seem to be more predictive of cardiovascular health than they are of freedom from cancer. So the benefits of health assets may be disease specific. A wider variety of diseases needs to be investigated from the positive health perspective. Moreover, research is not clear about the relative contribution of health assets to disease onset, to disease progression, and/or to recovery.

Positive Psychology Interventions for Physical Health

Researchers and practitioners have begun to develop intervention strategies based on positive psychology to increase positive psychological assets such as positive emotions or life satisfaction to bolster physical health. Whether increasing positive psychological assets will turn to better health outcomes is inconclusive. These intervention efforts targeting health assets in order to lead to better health not only have practical significance but also theoretical importance because appropriately done intervention studies would strengthen the claim that health assets actually cause good health.

We refer to interventions informed by positive psychology as positive psychology interventions. Sometimes positive psychology interventions entail a specific technique, like counting one’s blessings at the end of the day or using one’s signature strengths of character in novels ways. 47 At other times, the intervention uses a more-elaborated therapy package that combines different techniques, such as “Well-Being Therapy,” 48 and Quality of Life Therapy , 49 among others.

Intervention studies allow us to conclude that interventions informed by positive psychology can indeed change positive psychological states and traits, sometimes in lasting ways. 47 , 48 An important qualification is that long-term benefits do not result from one-shot interventions unless these lead to a change in how someone habitually lives. 18 Perhaps, what is required is a sustained lifestyle change.

On the face of it, intervening to increase a health asset should also have benefits for physical health, given the association between health assets and health outcomes. However, this argument does not embody a syllogism. Health assets may not be direct causes of good health, and even if they are, changing them may not result in better health. Said another way, we do not yet know if the health benefits of deliberately cultivated happiness or optimism or life meaning have the same benefits as their naturally occurring counterparts. 50

Needed is intervention research that incudes physical health as an explicitly measured outcome. While it is interesting and important to show that a positive psychology intervention increases the psychological well-being of medial patients, the more exciting issue is whether the intervention also affects their physical health. If so, how quickly would health benefits be evident? And what is the mechanism by which the intervention has an effect?

In studying the mechanisms by which a positive psychology intervention influences physical health, the role played by mundane behavior should not be neglected. 46 There are well-documented “healthy” ways of behaving, 51 including sleeping 8 hours a night, eating balanced meals, not smoking, not drinking to excess, and exercising regularly.

We suspect that positive psychology interventions, when successful, lead people not only to think and feel in more positive ways but also to behave in more healthy ways. 40 , 46 For example, optimistic people are more actively engaged with the world and are better problem solvers than their pessimistic counterparts. They have more frequent and higher quality social contacts as well as more social support. All of these factors may lead to healthier behaviors and habits and eventually to better health.

Positive psychology intervention studies for better health outcomes are in their infancy. So far, nearly all positive psychology interventions primarily targeted changing health-related behaviors such as physical activity, not the health outcome directly. Researchers have shown that positive psychology interventions influence some of the biological and behavioral processes implicated in good health. For example, inducing positive emotions speeds cardiovascular recovery following a stressful event. 52 Training in mindfulness meditation can boost immune function. 53 Psychosocial resilience training targeting positive emotions, cognitive flexibility, social support, life meaning, and active coping reduces total cholesterol among middle-aged adults. 54 Researchers have begun to investigate how positive affect and affirmation influence physical activity and medication adherence among patients with coronary artery disease, 55 asthma, 56 and hypertension. 57 The next step in each case is to show that such interventions also increase good health as opposed to its possible precursors.

Using a randomized controlled clinical trial, a group of researchers recently developed an intervention strategy that enhances positive affect and self-affirmation (PA/SA) and applied it to 3 different high-risk clinical populations (eg, hypertension, asthma, coronary artery disease) to change their health-related behaviors. 55 - 57

In each clinical trial, patients were randomly assigned to either the patient education (PE) control group or the positive-affect/self-affirmation (PA/SA) intervention group. For the control group, each patient received an educational workbook, a pedometer, and a behavior contract for a physical activity goal. For the intervention group, each received PE control components and additionally, a PA/SA workbook chapter, bimonthly induction of PA/SA by telephone, and small mailed gifts. Patients in the PA intervention group were taught how to self-induce positive affect and self-affirmation using a workbook chapter, received bimonthly inducement of PA/SA by telephone, and unexpected small gifts (PA) mailed bimonthly several weeks before follow-up calls. During PA/SA induction phone calls, patients were told to “think about things that make you feel good” and take a moment each day to enjoy positive thoughts (PA), and to think about “proud moments” in their personal lives if they have a difficult time exercising (SA). For both groups, data were collected through a standardized bimonthly telephone follow-up for 12 months.

Using this research design, researchers conducted 3 parallel studies. In study 1, 55 patients were recruited right after percutaneous coronary intervention to increase physical activity among people with coronary artery disease. Compared to the control group, patients in the intervention group engaged in significantly more physical activities. In study 2, 56 physical activity among asthma patients who participated in the study was improved without differences between control and intervention groups. There was no significant effectiveness of intervention. In study 3, 57 the intervention effect on enhancing medication adherence among hypertensive African Americans was examined. Patients in both control and intervention groups received a culturally appropriate hypertension self-management workbook, a behavioral contract, and bimonthly telephone calls to help them better handle barriers to medication adherence. In addition, patients in the PA/SA intervention group received small gifts and bimonthly telephone calls to help them utilize positive thoughts into their daily routine and foster self-affirmation. At the 12-month follow-up, the intervention group showed a significantly higher level of medication adherence compared to the control group (42% vs 36%). The reduction of blood pressure was found among participants without significant differences across groups.

Mixed results from these intervention studies leave questions that need to be clarified with more studies to better understand the effectiveness of a positive psychology intervention on the different health outcomes before they are implemented in health practices.

Another line of positive psychology intervention research that attracted significant attention in recent years is applications of mindfulness meditation. It is assumed that meditations induce positive affect and lead to good health. A study led by a neuroscientist, Richard Davidson, demonstrated that mindfulness meditation produces changes in brain and immune function in a positive way. 53 In this study, 25 healthy employees at a work site received an 8-week intensive clinical training in mindfulness meditation. A weekly training class met for about 3 hours, and a silent 7-hour retreat was held during week 6 of the training. In addition, participants were instructed to perform home meditation practices for 1 hour each day, 6 days a week with the guided audiotapes. Brain electrical activity was measured at the baseline, the end of training, and 4 months after training. Also at the end of training, participants were vaccinated with influenza vaccine. Results from the meditation group were compared to those of the wait-list control group. Among the meditation group, brain activity in the left-sided anterior, associated with positive affect, was significantly increased. They also found significant increases in antibody concentrations to influenza vaccine in the meditation group. Interestingly, the size of increase in left-sided activation predicted the size of antibody concentration rise to the vaccine.

In sum, the effects of positive psychology interventions on health outcomes are inconclusive. As stated before, positive psychology interventions seem to be more effective on reducing health risks among healthy individuals in the short term. However, its long-term health effects, especially, on a population with different health problems, is not clear.

Conclusions

Positive psychology is a perspective that urges scientific attention to strengths and assets that contribute to health and a flourishing life. We have described what positive psychologists have learned about the relationships between positive psychological assets and physical health in the past decade.

To date, the application of positive psychology to health is promising, although much work remains to be done. On the positive side, research shows that what we call positive psychological health assets (eg, positive emotions, life satisfaction, optimism, positive relationships, life purpose) are prospectively associated with good health measured in a variety of ways. Also on the positive side, interventions have been developed that increase these assets; lasting effects require a lifestyle change.

Not yet known is whether positive psychology interventions improve physical health, reducing morbidity and mortality, speeding recovery from illness, and so on. Investigators are beginning to study the health effects of such interventions. Studies to date suggest that positive psychology interventions reduce some of the biological and behavioral processes that affect health, but the next step is to study good health per se.

We urge an open mind about the eventual success of such interventions. It is important not to get too far ahead of the data. Perhaps these interventions will work as intended, perhaps not. For example, the lesson from studies of psychological interventions targeting negative states and traits such as anger and depression in the hope of reducing cardiovascular disease, with which they are associated, is instructive. The success of these interventions is checkered at best. 46 Whether the deliberate cultivation of positive health assets such as positive emotions or life purpose will be more successful in promoting good health than the reduction of psychological risk factors is not known, but is a question worth addressing.

In conclusion, growing evidence suggests that positive psychological assets are linked to health and longevity. However, more studies are necessary to learn more about when, why, how, and for whom positive psychological assets plays a role in good health and whether interventions that enhance these assets will yield health benefits. We urge a skeptical yet fair-minded attitude on the part of researchers and practitioners and that they pay particular attention to underlying mechanisms. Meanwhile, freedom from disease and longevity are not the only goals of life. Quality of life matters in addition to quantity of life. It is clear from research that experiencing frequent positive emotions, having sense of life purpose, paying attention to what is positive in life, and living a more socially integrated life is linked to one’s quality of life across the lifespan. Thus, helping people cultivate positive psychological and social assets in life has potential for leading to happier, more meaningful, and healthier lives.

Acknowledgments

Christopher Peterson unexpectedly died on October 9, 2012, during the revision of this article. We are deeply indebted to his scholarly contributions and mentorship not only to this work but also to the foundation of positive psychology and its applications to various fields. His intellectual and personal contributions will continue to inspire and guide the positive psychology and positive health community.

Support for the preparation of this article was provided by the Robert Wood Johnson Foundation’s Pioneer Portfolio, which supports innovative ideas that may lead to breakthroughs in the future of health and health care. The Pioneer Portfolio funding was administered through a Positive Health grant to the Positive Psychology Center at the University of Pennsylvania, Martin Seligman, Director.

• 1. World Health Organization. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946 Official Records of the World Health Organization. Geneva, Switzerland: World Health Organization; 1946. [ Google Scholar ]
• 2. Peterson C. A Primer in Positive Psychology. New York, NY: Oxford University Press; 2006. [ Google Scholar ]
• 3. Seligman MEP, Csikszentmihalyi M. Positive psychology: an introduction. Am Psychol. 2000;55:5-14. [ DOI ] [ PubMed ] [ Google Scholar ]
• 4. Peterson C, Park N. Positive psychology as the evenhanded positive psychologist views it. Psychol Inq. 2003;14:141-146. [ Google Scholar ]
• 5. Park N, Peterson C, Brunwasser SM. Positive psychology and therapy. In: Kazantzis N, Reinecke MA, Freeman A, eds. Cognitive and Behavioral Theories in Clinical Practice. New York, NY: Guilford; 2009:278-306. [ Google Scholar ]
• 6. Ryff CD, Singer BH, Love GD. Positive health: connecting well-being with biology. Philos Trans R Soc Lond B Biol Sci. 2004;359:1383-1394. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 7. Seeman J. Toward a model of positive health. Am Psychol. 1989;44:1099-1109. [ DOI ] [ PubMed ] [ Google Scholar ]
• 8. Seligman MEP. Positive health. Appl Psychol Int Rev. 2008;57:3-18. [ Google Scholar ]
• 9. Gold MR, Stevenson D, Fryback DG. HALYS and QALYS and DALYS, Oh My: similarities and differences in summary measures of population health. Annu Rev Public Health. 2002;23:115-134. [ DOI ] [ PubMed ] [ Google Scholar ]
• 10. Veenhoven R. Happy life-expectancy: a comprehensive measure of quality-of-life in nations. Soc Indic Res. 1996;39:1-58. [ Google Scholar ]
• 11. Watson D, Pennebaker JW. Health complaints, stress and distress: exploring the central role of negative affectivity. Psychol Rev. 1989;96:234-254. [ DOI ] [ PubMed ] [ Google Scholar ]
• 12. Watson D. Intraindividual and interindividual analyses of positive and negative affect: their relation to health complaints, perceived stress, and daily activities. J Pers Soc Psychol. 1988;54:1020-1030. [ DOI ] [ PubMed ] [ Google Scholar ]
• 13. Diener E, Emmons RA. The independence of positive and negative affect. J Pers Soc Psychol. 1985;47:71-75. [ DOI ] [ PubMed ] [ Google Scholar ]
• 14. Davidson R. Affective style, psychopathology, and resilience: brain mechanisms and plasticity. Am Psychol. 2000;55:1196-1214. [ DOI ] [ PubMed ] [ Google Scholar ]
• 15. Boehm JK, Kubzansky LD. The heart’s content: The association between positive psychological well-being and cardiovascular health. Psychol Bull. 2012;138:655-691. [ DOI ] [ PubMed ] [ Google Scholar ]
• 16. Cohen S, Pressman SD. Positive affect and health. Curr Dir Psychol Sci. 2006;15:122-125. [ Google Scholar ]
• 17. Diener E, Chan MY. Happy people live longer: subjective well-being contributes to health and longevity. Appl Psychol Health Wellbeing. 2011;3:1-43. [ Google Scholar ]
• 18. Boehm JK, Peterson C, Kinimaki M, Kubzansky LD. Heart health when life is satisfying: evidence from the Whitehall II cohort study. Eur Heart J. 2011;32:2672-2677. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 19. Kim ES, Park N, Peterson C. Dispositional optimism protects older adults from stroke: the Health and Retirement Study. Stroke. 2011;42:2855-2859. [ DOI ] [ PubMed ] [ Google Scholar ]
• 20. Peterson C. Explanatory style as a risk factor for illness. Cognit Ther Res. 1988;12:117-130. [ Google Scholar ]
• 21. Peterson C, Seligman MEP, Vaillant GE. Pessimistic explanatory style is a risk factor for physical illness: a thirty-five year longitudinal study. J Pers Soc Psychol. 1988;55:23-27. [ DOI ] [ PubMed ] [ Google Scholar ]
• 22. Rasmussen HN, Scheier MF, Greenhouse JB. Optimism and physical health: a meta-analytic review. Ann Behav Med. 2009;37:239-256. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 23. Lawler KA., Younger JW, Piferi RL, Jobe RL, Edmondson KA, Jones WH. The unique effects of forgiveness on health: an exploration of pathways. J Behav Med. 2005;28:157-167. [ DOI ] [ PubMed ] [ Google Scholar ]
• 24. Kubzansky LD, Park N, Peterson C, Vokonas P, Sparrow D. Healthy psychological functioning and incident coronary heart disease: the importance of self-regulation. Arch Gen Psychiatry. 2011;68:400-408. [ DOI ] [ PubMed ] [ Google Scholar ]
• 25. Boehm JK, Peterson C, Kivimaki M, Kubzansky LD. A prospective study of positive psychological well-being and coronary heart disease. Health Psychol. 2011;30:259-267. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 26. Boyle PA, Barnes LL, Buchman AS, Bennett DA. Purpose in life is associated with mortality among community-dwelling older persons. Psychosom Med. 2009;71:574-579. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 27. Kim ES, Sun JK, Park N, Kubzansky LD, Peterson C. Purpose in life and reduced risk of myocardial infarction among older U.S. adults with coronary heart disease: a two-year follow-up. J Behav Med. 2013;74:427-432. [ DOI ] [ PubMed ] [ Google Scholar ]
• 28. Koizumi M, Ito H, Kaneko Y, Motohashi Y. Effect of having a sense of purpose in life on the risk of death from cardiovascular diseases. J Epidemiol. 2008;18:191-196. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 29. Sone T, Nakaya N, Ohmori K, et al. Sense of life worth living (ikigai) and mortality in Japan: Ohsaki study. Psychosom Med. 2008;70:709-715. [ DOI ] [ PubMed ] [ Google Scholar ]
• 30. Post SG. Altruism, happiness, and health: it’s good to be good. Int J Behav Med. 2005;12:66-77. [ DOI ] [ PubMed ] [ Google Scholar ]
• 31. Sneed RS, Cohen S. A prospective study of volunteerism and hypertension risk in older adults. Psychol Aging. 2013;28:578-586. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 32. Konrath S, Fuhrel-Forbis A, Lou A, Brown S. Motives for volunteering are associated with mortality risk in older adults. Health Psychol. 2012;31:87-96. [ DOI ] [ PubMed ] [ Google Scholar ]
• 33. Cohen S. Social relationships and health. Am Psychol. 2004;59:676-684. [ DOI ] [ PubMed ] [ Google Scholar ]
• 34. Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med. 2010;7(7):e1000316. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 35. House JS, Landis KR, Umberson D. Social relationships and health. Science. 1988;241:540-545. [ DOI ] [ PubMed ] [ Google Scholar ]
• 36. Seybold KS, Hill PC. The role of religion and spirituality in mental and physical health. Curr Dir Psychol Sci. 2001;10:21-24. [ Google Scholar ]
• 37. Powell LH, Shahabi L, Thoresen CE. Religion and spirituality: linkages to physical health. Am Psychol. 2003;58:36-52. [ DOI ] [ PubMed ] [ Google Scholar ]
• 38. Danner DD, Snowdon DA, Friesen VW. Positive emotions in early life and longevity: findings from the nun study. J Pers Soc Psychol. 2000;80:804-813. [ PubMed ] [ Google Scholar ]
• 39. Cohen S, Doyle WJ, Turner RB, Alper CM, Skoner DP. Emotional style and susceptibility to the common cold. Psychosom Med. 2003;65:652-657. [ DOI ] [ PubMed ] [ Google Scholar ]
• 40. Peterson C. The future of optimism. Am Psychol. 2000;55:44-55. [ DOI ] [ PubMed ] [ Google Scholar ]
• 41. Segerstrom SC, Taylor SE, Kemeny ME, Fahey JL. Optimism is associated with mood, coping, and immune change in response to stress. J Pers Soc Psychol. 1998;74:1646-1655. [ DOI ] [ PubMed ] [ Google Scholar ]
• 42. Reed GM, Kemeny ME, Taylor SE, Vischer BR. Negative HIV-specific expectancies and AIDS-related bereavement as predictors of symptom onset in asymptomatic HIV-positive gay men. Health Psychol. 1999;18:354-363. [ DOI ] [ PubMed ] [ Google Scholar ]
• 43. Kubzansky LD, Wright RJ, Cohen S, Weiss S, Rosner B, Sparrow D. Breathing easy: a prospective study of optimism and pulmonary function in the normative aging study. Ann Behav Med. 2002;24:345-353. [ DOI ] [ PubMed ] [ Google Scholar ]
• 44. Achat H, Kawachi I, Spiro A, DeMolles DA, Sparrow D. Optimism and depression as predictors of physical and mental health functioning: the Normative Aging Study. Ann Behav Med. 2000;22:127-130. [ DOI ] [ PubMed ] [ Google Scholar ]
• 45. Kim ES, Park N, Peterson C. Dispositional optimism protects older adults from stroke: the health and retirement study. Stroke. 2011;42:2855-2859. [ DOI ] [ PubMed ] [ Google Scholar ]
• 46. Peterson C, Park N, Kim ES. Can optimism decrease the risk of illness and disease among the elderly? Aging Health. 2012;8:5-8. [ Google Scholar ]
• 47. Seligman MEP, Steen AT, Park N, Peterson C. Positive psychology progress: empirical validation of interventions. Am Psychol. 2005;60:410-421. [ DOI ] [ PubMed ] [ Google Scholar ]
• 48. Fava GA. Well-being therapy. Psychother Psychosom. 1997;68:171-178. [ DOI ] [ PubMed ] [ Google Scholar ]
• 49. Frisch MB. Quality of Life Therapy. New York, NY: Wiley; 2006. [ Google Scholar ]
• 50. Fordyce MW. Development of a program to increase personal happiness. J Couns Psychol. 1977;24:511-520. [ Google Scholar ]
• 51. Belloc NB, Breslow L. Relationship of physical health status and family practices. Prev Med. 1972;1:409-421. [ DOI ] [ PubMed ] [ Google Scholar ]
• 52. Fredrickson BL, Levenson RW. Positive emotions speed recovery from the cardiovascular sequelae of negative emotions. Cogn Emot. 1998;12:191-220. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 53. Davidson RJ, Kabat-Zinn J, Schumacher J, et al. Alterations in brain and immune function produced by mindfulness meditation. Psychosom Med. 2003;65:564-570. [ DOI ] [ PubMed ] [ Google Scholar ]
• 54. Burton NW, Pakenham KI, Brown WJ. Feasibility and effectiveness of psychosocial resilience training: a pilot study of the READY program. Psychol Health Med. 2010;15:266-277. [ DOI ] [ PubMed ] [ Google Scholar ]
• 55. Peterson JC, Charlson ME, Hoffman Z, et al. A randomized controlled trial of positive-affect induction to promote physical activity after percutaneous coronary intervention. Arch Intern Med. 2012;172:329-336. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 56. Mancuso CA, Choi TN, Westermann H, et al. Increasing physical activity in patients with asthma through positive affect and self-affirmation: a randomized trial. Arch Intern Med. 2012;172:337-343. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 57. Ogedegbe GO, Boutin-Foster C, Wells MT, et al. A randomized controlled trial of positive-affect intervention and medication adherence in hypertensive African Americans. Arch Intern Med. 2012;172:322-326. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
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Mental Health Promotion in Public Health: Perspectives and Strategies From Positive Psychology

Rosemarie kobau , mph, mapp, martin ep seligman , phd, christopher peterson , phd, ed diener , phd, matthew m zack , md, mph, daniel chapman , phd, william thompson , phd.

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Correspondence should be sent to Rosemarie Kobau, MPH, MAPP; CDC, NCCDPHP, Division of Adult and Community Health; Arthritis, Epilepsy, and Quality of Life Branch; 4770 Buford Highway NE, MS K-51; Atlanta, GA 30341 (e-mail: [email protected] ). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints/Eprints” link.

Note. The findings and conclusions of this essay are those of the authors and do not necessarily represent the official position of the US Department of Health and Human Services, the US Public Health Service, or the Centers for Disease Control and Prevention.

Contributors

R. Kobau conceptualized, drafted, and finalized the essay. All authors provided expertise and editorial comments and approved the final article.

Corresponding author.

Accepted 2010 Nov 19.

Positive psychology is the study of what is “right” about people—their positive attributes, psychological assets, and strengths. Its aim is to understand and foster the factors that allow individuals, communities, and societies to thrive.

Cross-sectional, experimental, and longitudinal research demonstrates that positive emotions are associated with numerous benefits related to health, work, family, and economic status. Growing biomedical research supports the view that positive emotions are not merely the opposite of negative emotions but may be independent dimensions of mental affect.

The asset-based paradigms of positive psychology offer new approaches for bolstering psychological resilience and promoting mental health. Ultimately, greater synergy between positive psychology and public health might help promote mental health in innovative ways.

Mental health promotion seeks to foster individual competencies, resources, and psychological strengths, and to strengthen community assets to prevent mental disorder and enhance well-being and quality of life for people and communities. 1 – 4 Positive psychology is the study of such competencies and resources, or what is “right” about people—their positive attributes, psychological assets, and strengths. 5 Its mission is to understand and foster the factors that allow individuals, communities, and societies to thrive. 5 , 6 It complements theories and models of individual, community, and organizational deficits with theories and models of assets. 7 Positive psychology offers new approaches for bolstering psychological resilience and for promoting mental health, and thus may enhance efforts of health promotion generally and of mental health promotion specifically. 1 – 4 , 7 – 10

Health promotion strategies, in general, include implementing health-enhancing public policy (employment opportunities, antidiscriminatory laws), creating supportive environments (parenting interventions), strengthening community action (participatory research, media campaigns), developing personal skills (resilience), and reorienting health services (postpartum depression screening) to enhance health. 1 , 2 , 11 – 13 Public health has focused its efforts on these health determinants primarily as they relate to preventing physical illness, injury, and disability, resulting in increased longevity. 14 , 15 Similarly, clinical psychiatry and psychology have been successful in identifying, classifying, and treating mental illness and disorder, resulting in better quality of life for many. However, just as the 1986 Ottawa Charter for Health Promotion 13 shifted greater attention in public health from disease prevention to health promotion, positive psychology shifts attention from pathology and dysfunction to positive emotions and optimal functioning. Underlying both of these shifts are the fundamental views that health is more than the absence of illness and that fostering individual and social resources can lead people, organizations, and communities to thrive.

In public health, this shift has also become evident in the field of mental health promotion, seen as an integral part of health promotion practice. 1 – 3 , 12 , 16 Common to both mental health promotion and positive psychology is a focus on “positive mental health,” an empowering resource, broadly inclusive of psychological assets and skills essential to human fulfillment and well-being. 1 , 3 , 4 Activities and programs that foster positive mental health also help to prevent mental illness, highlighting the benefits of mental health promotion to overall population health. 2 Assessment of positive mental health and related outcomes such as well-being can help in supporting and evaluating health promotion and public health wellness initiatives. 17 Thus, positive psychology deserves a place in health promotion, and health promotion theory and methods can enhance positive psychology research and practice to improve population mental health. 7 , 8 , 17 – 19

Whereas discourse on human fulfillment is rooted in ancient Western and Eastern philosophy, as well as in more recent disciplines of human development and humanistic and educational psychology, positive psychology applies a common language and an empirical approach to the study of 4 areas: (1) positive emotions (happiness, gratitude, fulfillment), (2) positive individual traits (optimism, resiliency, character strengths), (3) positive relationships among groups, and (4) enabling institutions (schools, worksites) that foster positive outcomes. 5 , 18 , 20 – 24 This contrasts with post–World War II psychology, which concentrated on repairing damage using the prevailing disease model of human functioning (i.e., mental ill health), while largely ignoring psychological assets (e.g., courage, kindness) and positive aspects of behavior (e.g., responsibility, compassion) that could also assist in therapy. 25 The focus on mental ill health—its causes, symptoms, and consequences—resulted in stigma associated with these factors, euphemistic use of the term “mental health” to describe treatment and support services for people with mental illness, and vague language, especially among the public, about what mental health means. 1

Positive psychology does not claim that mainstream psychology is negative or less important because it focuses on pathology and mental illness. Its aim is not to deny the distressing or unpleasant aspects of life; the value of negative experiences on human development, coping, and creativity; or the critical need to ameliorate distress. 23 , 26 Despite what its critics say, positive psychology seeks to provide a more complete scientific understanding of the human experience—including positive and negative experiences—to better integrate and complement existing knowledge about mental illness with knowledge about positive mental health. 23 , 24 , 27 , 28 Researchers have addressed these critics' objections, which are primarily concerned with adaptation, goals, temperament, heritability, forecasting, recall biases, and accurately measuring or intervening on well-being. 29 – 36 Research from multiple disciplines suggests that positive mental health and well-being can be measured relatively accurately and that appropriately targeted interventions can affect well-being. 4 , 24 , 30 , 35 , 36 However, more research in positive psychology that generalizes to the broad population is warranted. Given the benefits of positive emotions, positive psychology parallels efforts in mental health promotion to advance the value of positive mental health in individuals and society. 1 – 4 We present a brief overview on the benefits of positive emotions, the recognition and impact of positive individual traits for mental health promotion, and the influence of enabling social-environmental factors on positive mental health.

POSITIVE EMOTIONS

Many people know about the benefits of negative emotions such as fear, disgust, and anger in securing our personal safety and survival (e.g., fight or flight), and the harms of increased stress levels, narrowed responses for action, and withdrawal associated with negative emotions. Fewer know that positive emotions (e.g., joy, interest, contentment) quell autonomic arousal, signal approach and safety, and prompt individuals to engage with their physical and social environments by exploring new objects, people, or situations (for reviews, see Fredrickson 6 , 37 , 38 and Tugade et al. 39 ). Although sometimes confused with related affective states such as short-term sensory pleasure (e.g., satiety, warmth) and longer-lasting positive moods, positive emotions are typically brief and result from personally meaningful circumstances (e.g., joy from a social encounter).

Broaden and Build

The Broaden and Build theory of positive emotions proposes that positive emotions broaden people's attention, expand cognition (e.g., curiosity, creativity) and behaviors (e.g., exploration, play), and consequently foster physical, intellectual, and social resources (e.g., intelligence, mastery, social competence) for optimal functioning. 6 , 37 , 38 So, whereas negative emotions are adaptive in the short term, positive emotions may be adaptive in the longer term by building personal resources that function as psychological reserves for continued growth. 6 , 38 , 39

Regulating Negative Emotions

Moreover, positive emotions can more quickly quell or undo the adverse effects of negative experiences by reducing stressful reactions (e.g., increased blood pressure) and returning the body to a balanced state. 6 , 40 , 41 For example, in previous studies, individuals in whom positive emotions such as contentment and mild joy were prompted immediately after a stressful situation had faster cardiovascular recovery (e.g., reduced heart rate, peripheral vasoconstriction, and blood pressure) than did those in a control group. 6 , 40 According to the Broaden and Build theory, resilient people experience positive emotions more frequently and recover more quickly from specific life stressors. 6 , 38 , 39

Biological Markers of Positive Emotions

Positive emotions have numerous health, job, family, and economic benefits. 31 , 42 – 44 In numerous cross-sectional studies, positive emotions and positive evaluations of life are associated with decreased risk of disease, illness, and injury; healthier behaviors; better immune functioning; speedier recovery; and increased longevity. 31 , 40 , 43 – 46 Longitudinal and experimental studies show that positive emotions precede many successful outcomes related to work, social relationships, and physical health. 44 Growing biomedical and related research supports the view that positive emotions are not merely the opposite of negative emotions but independent dimensions of mental affect. 47 , 48 Positive emotions and negative emotions appear to have different determinants, consequences, and correlates, but differentiating these requires more study. 44 , 49 , 50

Positive emotions are partially heritable (estimates of heritability range from 0.36 to 0.81), suggesting a genetically determined set point for emotions such as happiness and sadness. 51 – 55 The expression of genetic effects, however, often results from environmental stimuli; social context matters because it can affect the opportunity for, and the frequency of, expressing positive emotions. 30 , 53 (The frequency of positive emotions predicts well-being better than does their intensity. 44 ) Furthermore, individuals' circumstances and social contexts are amenable to intervention by public health, mental health, and positive psychology practitioners. Several interventions described in this essay and elsewhere have succeeded in boosting positive emotions and minimizing negative affect and depression over time. 36 , 53 , 56

This growing literature demonstrates that positive emotions are important psychological resources to be nurtured, rather than only enjoyed as brief, elusive outcomes. 4 , 6 , 31 , 37 , 38 , 44 Positive psychology interventions (e.g., those that promote resiliency, optimism, or gratitude) may enhance the value of public health interventions based on effective behavioral science theories (e.g., Stages of Change) 57 and methodologies (e.g., motivational interviewing) in improving health outcomes. Framing individual and population health communication messages around positive experiences and emotions may foster behavior change better than using messages based on fear. 8 For example, Kaiser Permanente's “Thrive” campaign links its brand and its health services with the theme of living life fully and happily, and may be morale boosting for some. 58 , 59

POSITIVE INDIVIDUAL TRAITS

Positive individual traits include a number of positive dispositions present in individuals to different degrees, such as creativity, bravery, kindness, perseverance, and optimism, which, when cultivated, can increase resiliency, buffer against psychological disorder and other adversities, and promote mental health. 18 Several methods exist to help individuals improve their resiliency and identify their positive dispositions.

Resiliency and Optimism

Resiliency is the process of positive adaptation in the context of adversity or risk. 1 , 4 , 60 Resiliency helps people to cope with life's challenges and confers a sense of mastery over one's life. 1 , 4 Promotion of resiliency can occur within persons (e.g., coping, optimism), among persons (social support), and across social levels (public health or educational systems). 60 Studies of resiliency focus on positive adaptation and achievement and stress the importance of promoting competence (e.g., autonomy, goal-directed behavior) through interventions. 4 , 61 Substantial public health efforts are designed to promote resiliency among persons and across social levels. For example, prevention programs that safeguard against illness and injury might promote resiliency directly (e.g., vaccinations, nutritional fortification of foods) or indirectly (e.g., after-school programs). 1 The US Administration on Aging supports congregate meal programs through its network of Area Agencies on Aging, not only to provide meals to older adults but also to promote social interaction and social support that may confer greater psychological resiliency. 62 Parenting interventions and preschool interventions are effective in boosting resiliency in mothers and children. 1 , 2 , 4

Positive psychology offers several approaches for improving individual resiliency that may be relevant for public health interventions aimed at schools, worksites, health care settings, and Area Agencies on Aging. For example, individuals can change their “explanatory style”—that is, how they interpret day-to-day events and their interactions with others. 4 , 63 – 65 Specifically, they can learn skills for more optimistic ways of thinking and reacting to improve their resiliency. 4 , 63 Besides certain personality characteristics (e.g., dispositional optimism) and the physical and social environment, explanatory style can predict depression and other negative physical health outcomes. 66 , 67 Skills based on learned optimism—such as challenging beliefs, avoiding thinking traps, calming and focusing, and putting things in perspective—can improve psychological resiliency in individuals. These skills closely resemble “cognitive symptom management,” effectively used in interventions such as the Chronic Disease Self-Management Program. 68 However, expanding the use of skills like learned optimism to the broad population holds promise for promoting mental health. 63 , 64 , 69 , 70

The Penn Resiliency Program (PRP) is a group intervention delivered to children aged 8 to 15 years after school that teaches resiliency skills based on learned optimism. The PRP has been effectively implemented in the United States, United Kingdom, Australia, China, and Portugal, providing evidence of its effectiveness in diverse cultural settings. 2 , 70 , 71 Students learn to adopt more optimistic explanatory styles by detecting inaccurate thoughts, evaluating the accuracy of those thoughts, and challenging negative beliefs by considering alternative interpretations. 70 , 71 Students also learn how to negotiate, make decisions, and relax. In 21 studies (most of which used randomized controlled designs) that comprised about 3000 children, the PRP prevented disruptive behaviors for up to 36 months and depression and anxiety symptoms for up to 2 years, especially in students with more severe symptoms. 70 – 73 Thus, a mental health promotion intervention like the PRP may reduce the likelihood of onset of mental illness in children, but it requires more study. 74 The PRP works equally well among boys and girls and for children of various racial/ethnic backgrounds. 70 , 74 Similar school-based interventions have demonstrated improvements in empathy, cooperation, assertiveness, self-control, coping skills, resilience, and other social competencies aligned with positive mental health outcomes. 2,70

The US Army is applying resiliency training modeled after the PRP through its Comprehensive Soldier Fitness Program 75 to support the optimal mental and physical health of soldiers. As of October 1, 2009, the Army has supported resiliency training for its entire staff. The Comprehensive Soldier Fitness Program focuses on 5 dimensions of functioning: physical, emotional, spiritual, family, and social. It includes an anonymous, confidential, online self-assessment for all soldiers and will include a similar assessment for family members that will guide training needs. Resiliency skills to be taught include problem solving, energy management, explanatory style, and putting things in perspective. The Army is training master trainers to help other soldiers learn resiliency techniques. Additional pre- and postdeployment boosters will be implemented. 75

Learned optimism is not about looking at the world through rose-colored glasses or having unrealistic or self-deceptive expectations. 76 Instead, it is about teaching skills needed to promote mental health and to avoid excessive worry, rumination, or spirals of negative thinking. 63 , 64 Resiliency interventions such as the PRP might be disseminated more broadly in schools, worksites, and other community settings. 1 , 2 , 4

Character Strengths

With respect to mental illness, professionals have applied a common language and diagnostic criteria to identify and treat mental illness using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ( DSM-IV ). 77 However, the DSM-IV is explicitly designed to diagnose and treat mental illness but provides no guidance to assess positive thoughts, emotions, or behaviors. 78 , 79 In 2000, with growing interest and support from the field of positive youth development, Peterson and Seligman organized a research team to develop a scientific classification scheme comparable to the DSM-IV as well as assessment strategies to identify psychological strengths. 79 After extensively reviewing literature from multiple disciplines, this team considered cross-cultural validity, possible unintended political consequences of their effort (e.g., value-laden applications, such as selecting people on the basis of strengths), and the implications of creating a classification system versus a taxonomy. 79 Team members assumed that character, like traits, was stable and general and that character strengths were not bound to culture. They then identified explicit criteria that guided their classification system to identify character strengths of human goodness and excellence of character ( see box on this page ).

Criteria Used by Positive Psychologists for Classifying Strengths of Human Goodness and Excellence of Character

A character strength—

Is ubiquitous: is widely recognized across cultures (e.g., bravery, kindness).

Is fulfilling: contributes to individual fulfillment, satisfaction, and happiness broadly construed.

Is morally valued: is valued in its own right and not for tangible outcomes it may produce.

Does not diminish others: elevates others who witness it.

Has a nonfelicitous opposite: has obvious antonyms that are negative.

Is traitlike: is an individual difference with demonstrable generality and stability.

Is measureable: has been successfully measured by researchers as an individual difference.

Is distinct: is not redundant (conceptually or empirically) with other character strengths.

Has paragons: is strikingly embodied in some individuals.

Has prodigies: is precociously shown by some children or youths.

Can be selectively absent: is missing altogether in some individuals.

Has enabling institutions: is the deliberate target of societal practices and rituals that try to cultivate it.

Source . Peterson and Seligman. 79

Finally, they developed and validated the Values in Action Inventory of Strengths (VIA-IS) to measure these character strengths. The VIA-IS includes 6 core or “signature” strengths, each with 3 to 4 component definitions ( Table 1 ). Signature strengths are the mental and physical activities that we perceive as natural and desirable and that energize rather than exhaust us. 78 The VIA-IS, completed by a million individuals in more than 200 nations since 2002, has acceptable construct validity, discriminant validity, convergent validity, stability and internal consistency reliability, and test-retest reliability. 21 , 80 – 83 The VIA-IS has also been modified and validated for use in youths aged 10 to 17 years (VIA-Youth). 83

Core Strengths of Human Goodness and Character as Recognized by Positive Psychology

Source. Peterson and Seligman. 79

The VIA-IS is available for public use 84 and, as part of the survey assessment, provides users with their strengths' rankings (so they can see where their strengths rank compared with other strengths), along with examples of methods to enhance strengths. Park and Peterson 83 have provided information on scoring, and Peterson 21 has described methods to practice using signature strengths in new and different ways (i.e., reinforcing the strength) for mental health promotion. One Internet-based intervention encouraging people to use their strengths in new ways increased happiness and decreased depressive symptoms for 6 months. 24 Such strengths-based development has been linked to many positive outcomes in educational and workplace settings. 85 The public availability of the VIA-IS, its broad approach to characterizing individual strengths, and its psychometric properties make it potentially appealing for behavioral science intervention research as well as for health communication messaging.

Although more research is needed regarding its psychometric properties in diverse sociodemographic subgroups, the VIA-IS offers good face validity for use in communities. For example, among 383 African American adolescents surveyed with the VIA-Youth, love of learning was related to self-reported abstinence for boys and self-reported avoidance of drug use for boys and girls. 86 In a Department of Veterans Affairs psychiatric rehabilitation program to promote recovery from mental illness, simply taking the VIA-IS was described as an intervention itself, with most participants reporting positive outcomes associated with the experience. 9 The study investigators encouraged veterans to use prompts such as a “strengths card,” which they carried with them as a reminder of their positive attributes and as help in their daily recovery.

Applying the VIA-IS could also be useful to those coping with other chronic diseases. For example, parents might devise ways to use their children's VIA strengths to help them better manage chronic illness. Additional studies of character strengths may show that these strengths buffer against risky health behaviors or adverse health outcomes. Such studies may help target health promotion messages and health marketing strategies to motivate groups in ways that complement their self-perceived strengths. However, because the VIA-IS is based solely on self-report, it is still unclear whether and how it relates to more objective measures of strengths, whether the strengths it identifies are enduring, and whether strength-based interventions are effective over the long term.

Although a comprehensive review of interventions that improve positive emotions is beyond the scope of this essay, practicing gratitude, performing acts of kindness, and mindfulness relaxation (nonjudgmentally focusing awareness on thoughts, sights, and sounds) can increase positive emotions and well-being. 36 , 56 , 87 Gratitude helps people to savor their life experiences and situations, maximize satisfaction and enjoyment from those experiences, and minimize adaptation. 54 Gratitude might also help people to cope with stress and trauma by positively reinterpreting negative life experiences. 33 , 88 Relative to control groups, participants who were asked to write down 5 things for which they were grateful (e.g., cherished interactions, overcoming obstacles) once a week for 10 weeks reported greater life satisfaction, more optimism, and fewer health complaints. 56 Other gratitude exercises improved positive affect and physical activity, 36 , 56 , 88 sleep quality, 89 and prosocial behavior. 90 Students who performed and tracked random acts of kindness increased their happiness relative to that of a control group. 36 , 91 Additional examples of interventions that have been shown to increase individual positive emotions and well-being are available, 22 , 36 as are examples of their use in schools. 70

SOCIAL-ENVIRONMENTAL FACTORS AND ENABLING INSTITUTIONS

Social and economic factors influence health and mental health, including access to employment; safe working conditions; education, income, and housing; stable and supportive family, social, and community environments characterized by opportunities for autonomy, social inclusion, and freedom from discrimination and violence; and taxation of addictive substances to prevent abuse. 1 – 4 Institutions such as schools, homes, worksites, places of worship, and health care settings that have been traditional targets for public health disease prevention and health promotion interventions also are settings for evidence-based mental health promotion interventions. 2 Policy initiatives that affect social and economic determinants of mental health (e.g., housing, employment) and that support the integration of evidence-based mental health promotion programs in community settings are warranted to improve population health. 1 , 4

For those interested in fostering community or organizational change for mental health promotion, Appreciative Inquiry, a method closely aligned with positive psychology, holds promise. 92 Appreciative Inquiry is a systematic development and improvement process for management and organizational change based on deliberately positive assumptions about people, organizations, and relationships. 92 Its processes shift the focus and dialogue from problem solving to fostering assets by seeking to examine the strengths in a group, thus providing the starting point for positive change. In a typical Appreciative Inquiry session, participants are led through a series of systematic and provocative but affirming questions to identify what is positive in the group and to connect people in ways that heighten energy, vision, and action for change. 92 , 93

Appreciative Inquiry has been successfully and innovatively used by numerous private and governmental organizations, including the Cleveland Clinic, the National Aeronautics and Space Administration, the US Navy, Save the Children, the United Nations Global Compact, Imagine Chicago, Imagine Nagaland (India), and the United Kingdom's National Health Service. 92 – 94 Nursing has also frequently used Appreciative Inquiry to enhance education, management, and clinical care outcomes. 95 – 99 It may supplement current health behavior change models for health promotion. 7 For example, health care providers, health educators, and other caregivers might incorporate Appreciative Inquiry in their interactions with patients, clients, families, or groups to help them focus on capabilities and competencies related to a healthy lifestyle. A provider might ask a patient a few questions from an Appreciative Inquiry perspective to help motivate behavior change or to help assist in sustaining behavior change ( Table 2 ). Extensive resources exist to incorporate Appreciative Inquiry principles into daily settings or to more formally structure an Appreciative Inquiry summit for groups or organizations. 92 , 93 The implementation and effectiveness of Appreciative Inquiry in health promotion warrants more thought and study.

Use of Appreciative Inquiry as a Health Behavior Change Intervention Between a Clinician or Health Educator and a Client

Note. Discover, dream, design, and deliver are the 4 phases that guide Appreciative Inquiry. 92

Source. Modified from Moore and Charvat. 7

CONCLUSIONS

Positive mental health is a resource for everyday living and results from individual and community assets. The health promotion theories, methodologies, and populations available through public health partners offer greater reach for positive psychology practitioners to implement and evaluate their interventions across diverse sociodemographic subgroups and community settings that currently receive little attention. Likewise, the asset-based and affirmation paradigms of positive psychology offer additional strategies for mental health promotion. Mental health promotion and positive psychology offer the public (1) an updated way of thinking about mental health that provides for the richness of human experience, (2) additional ways to describe and value the full spectrum of mental health to lessen the stigma associated with mental illness and to initiate conversations about mental health, 100 (3) enhancement of psychological screening, 101 and (4) evidence-based individual, community, and social interventions that can enhance positive mental health. 1 , 2 , 4 , 31 Ultimately, greater synergy between positive psychology and public health might help promote positive mental health in innovative ways that can improve overall population health.

Human Participant Protection

No protocol approval was needed because no human participants were involved in this endeavor.

• 1. Herrman HS, Saxena S, Moodie R. Promoting Mental Health: Concepts, Emerging Evidence, Practice. A WHO Report in Collaboration With the Victoria Health Promotion Foundation and the University of Melbourne. Geneva, Switzerland: World Health Organization; 2005. Available at: http://www.who.int/mental_health/evidence/MH_Promotion_Book.pdf . Accessed October 1, 2010 [ Google Scholar ]
• 2. Jané-Llopis E, Barry M, Hosman C, Patel V. Mental health promotion works: a review. Promot Educ. 2005;(suppl 2):9–25, 61, 67 [ DOI ] [ PubMed ] [ Google Scholar ]
• 3. Barry MM, Jenkins R. Implementing Mental Health Promotion. Oxford, England: Churchill Livingstone, Elsevier; 2007 [ Google Scholar ]
• 4. Friedli L. Mental Health, Resilience and Inequalities. Copenhagen, Denmark: WHO Regional Office for Europe; 2009 [ Google Scholar ]
• 5. Seligman MEP, Csikszentmihalyi M. Positive psychology: an introduction. Am Psychol. 2000;55(1):5–14 [ DOI ] [ PubMed ] [ Google Scholar ]
• 6. Fredrickson BL. The role of positive emotions in positive psychology. Am Psychol. 2001;56(3):218–226 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 7. Moore SM, Charvat J. Promoting health behavior change using appreciative inquiry: moving from deficit models to affirmation models of care. Fam Community Health. 2007;30(1 suppl):S64–S74 [ DOI ] [ PubMed ] [ Google Scholar ]
• 8. Taylor SE, Sherman DK. Positive psychology and health psychology: a fruitful liaison. : Linley PA, Joseph S, Positive Psychology in Practice. Hoboken, NJ: John Wiley & Sons; 2004:305–319 [ Google Scholar ]
• 9. Resnick SG, Rosenheck R. Recovery and positive psychology: parallel themes and potential synergies. Psychiatr Serv. 2006;57(1):120–122 [ DOI ] [ PubMed ] [ Google Scholar ]
• 10. Hershberger PJ. Prescribing happiness: positive psychology and family medicine. Fam Med. 2005;37(9):630–634 [ PubMed ] [ Google Scholar ]
• 11. National Research Council New Horizons in Health: An Integrative Approach. Singer BH, Ryff CD, Washington, DC: National Academies Press; 2001 [ PubMed ] [ Google Scholar ]
• 12. Jané-Llopis E. Mental health promotion: concepts and strategies for reaching the population. Health Promot J Austr. 2007;18(3):191–197 [ DOI ] [ PubMed ] [ Google Scholar ]
• 13. World Health Organization The Ottawa Charter for Health Promotion: First International Conference on Health Promotion, Ottawa, 21 November 1986. Available at: http://www.who.int/healthpromotion/conferences/previous/ottawa/en . Accessed December 1, 2009 [ Google Scholar ]
• 14. Centers for Disease Control and Prevention Public health and aging: trends in aging–United States and worldwide. MMWR Morb Mortal Wkly Rep. 2003;52(06);101–106 Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5206a2.htm . Accessed December 7, 2009 [ PubMed ] [ Google Scholar ]
• 15. Centers for Disease Control and Prevention Ten great public health achievements—United States, 1900–1999. MMWR Wkly Rep. 1999;48(12):241–243 Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/00056796.htm . Accessed March 31, 2011 [ PubMed ] [ Google Scholar ]
• 16. Walker L, Rowling L.Debates and confusion, collaboration, and emerging practice. : Rowling L, Martin G, Walker L, Mental Health Promotion and Young People: Concepts and Practice. Sydney, Australia: McGraw-Hill; 2002:4–10 [ Google Scholar ]
• 17. Russell-Mayhew S. Key concepts from health promotion evaluations: what psychology needs to know. Int J Adv Couns. 2006;28(2):167–182 [ Google Scholar ]
• 18. Seligman MEP. Authentic Happiness. New York, NY: Free Press; 2002 [ Google Scholar ]
• 19. Bull T. Hunting happiness or promoting health? Why positive psychology deserves a place in health promotion. Promot Educ. 2008;15(3):34–35 [ DOI ] [ PubMed ] [ Google Scholar ]
• 20. Peterson C, Seligman MEP. Positive organizational studies: thirteen lessons from positive psychology. : Cameron KS, Dutton JE, Quinn RE, Positive Organizational Scholarship: Foundations of a New Discipline. San Francisco, CA: Berrett-Koehler; 2003:14–27 [ Google Scholar ]
• 21. Peterson C. A Primer in Positive Psychology. New York, NY: Oxford University Press; 2006 [ Google Scholar ]
• 22. Linley PA, Joseph S. Applied positive psychology: a new perspective for professional practice. : Linley PA, Joseph S, Positive Psychology in Practice. Hoboken, NJ: John Wiley & Sons; 2004:3–14 [ Google Scholar ]
• 23. Gable SL, Haidt J. What (and why) is positive psychology? Rev Gen Psychol. 2005;9(2):103–110 [ Google Scholar ]
• 24. Seligman MEP, Steen TA, Park N, Peterson C. Positive psychology progress: empirical validation of interventions. Am Psychol. 2005;60(5):410–421 [ DOI ] [ PubMed ] [ Google Scholar ]
• 25. Seligman MEP. Positive psychology, positive prevention, and positive therapy. : Snyder CR, Lopez SJ, Handbook of Positive Psychology. New York, NY: Oxford University Press; 2005:3–12 [ Google Scholar ]
• 26. Linley PA, Joseph S. The human capacity for growth through adversity. Am Psychol. 2005;60(3):262–264 [ DOI ] [ PubMed ] [ Google Scholar ]
• 27. La Torre MA. Positive psychology: is there too much of a push? Perspect Psychiatr Care. 2007;43(3):151–153 [ DOI ] [ PubMed ] [ Google Scholar ]
• 28. Ehrenreich B. Bright-Sided: How the Relentless Promotion of Positive Thinking Has Undermined America. New York, NY: Henry Holt & Company; 2009 [ Google Scholar ]
• 29. Diener E. Subjective well-being. Am Psychol. 2000;55(1):34–43 [ PubMed ] [ Google Scholar ]
• 30. Diener E, Lucas R, Schimmack U, Helliwell J. Well-Being for Public Policy. New York, NY: Oxford University Press; 2009 [ Google Scholar ]
• 31. Diener E, Biswas-Diener R. Happiness: Unlocking the Mysteries of Psychological Wealth. Malden, MA: Blackwell Publishing; 2008 [ Google Scholar ]
• 32. Easterlin RA. Explaining happiness. Proc Natl Acad Sci U S A. 2003;100(19):11176–11183 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 33. Kahneman D, Diener E, Schwarz N. Well-Being: The Foundations of Hedonic Psychology. New York, NY: Russell Sage Foundation; 1999 [ Google Scholar ]
• 34. Eid M, Larsen RJ. The Science of Subjective Well-Being. New York, NY: Guildford Press; 2008 [ Google Scholar ]
• 35. King LA. Interventions for enhancing subjective well-being: can we make people happier and should we? : Eid M, Larsen RJ, The Science of Subjective Well-Being. New York, NY: Guildford Press; 2008:431–448 [ Google Scholar ]
• 36. Lyuobomirsky S. The How of Happiness. New York, NY: Penguin Group; 2008 [ Google Scholar ]
• 37. Fredrickson BL. What good are positive emotions? Rev Gen Psychol. 1998;2(3):300–319 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 38. Fredrickson BL. Positive emotions. In: Snyder CR, Lopez SJ, Handbook of Positive Psychology. New York, NY: Oxford University Press; 2005:120–134 [ Google Scholar ]
• 39. Tugade MM, Fredrickson BL, Barrett LF. Psychological resilience and positive emotional granularity: examining the benefits of positive emotions on coping and health. J Pers. 2004;72(6):1161–1190 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 40. Fredrickson BL, Levenson RW. Positive emotions speed recovery from the cardiovascular sequelae of negative emotions. Cogn Emot. 1998;12(2):191–220 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 41. Fredrickson BL, Mancuso RA, Branigan C, Tugade M. The undoing effect of positive emotions. Motiv Emot. 2000;24(4):237–258 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 42. Diener E, Seligman MEP. Beyond money: toward an economy of well-being. Psychol Sci Public Interest. 2004;5(1):1–31 [ DOI ] [ PubMed ] [ Google Scholar ]
• 43. Pressman SD, Cohen S. Does positive affect influence health? Psychol Bull. 2005;131(6):925–971 [ DOI ] [ PubMed ] [ Google Scholar ]
• 44. Lyubomirsky S, King L, Diener E. The benefits of frequent positive affect: does happiness lead to success? Psychol Bull. 2005;131(6):803–855 [ DOI ] [ PubMed ] [ Google Scholar ]
• 45. Ostir GV, Markides KS, Black SA, Goodwin JS. Emotional well-being predicts subsequent functional independence and survival. J Am Geriatr Soc. 2000;48(5):473–478 [ DOI ] [ PubMed ] [ Google Scholar ]
• 46. Ostir GV, Markides KS, Peek MK, Goodwin JS. The association between emotional well-being and incidence of stroke in older adults. Psychosom Med. 2001;63(2):210–215 [ DOI ] [ PubMed ] [ Google Scholar ]
• 47. Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988;54(6):1063–1070 [ DOI ] [ PubMed ] [ Google Scholar ]
• 48. Watson D, Clark LA. Measurement and mismeasurement of mood: recurrent and emergent issues. J Pers Assess. 1997;68(2):267–296 [ DOI ] [ PubMed ] [ Google Scholar ]
• 49. Ryff CD, Love GD, Urry LH, et al. Psychological well-being and ill-being: do they have distinct or mirrored biological correlates? Psychother Psychosom. 2006;75(2):85–95 [ DOI ] [ PubMed ] [ Google Scholar ]
• 50. Steptoe A, O'Donnell K, Badrick E, Kumari M, Marmot M. Neuroendocrine and inflammatory factors associated with positive affect in healthy men and women. Am J Epidemiol. 2007;167(1):96–102 [ DOI ] [ PubMed ] [ Google Scholar ]
• 51. Lykken D, Tellegen A. Happiness is a stochastic phenomenon. Psychol Sci. 1996;7(3):186–189 [ Google Scholar ]
• 52. Tellegen A, Lykken DT, Bouchard TJ, Wilcox KJ, Segal NL, Stephen R. Personality similarity in twins reared apart and together. J Pers Soc Psychol. 1988;54(6):1031–1039 [ DOI ] [ PubMed ] [ Google Scholar ]
• 53. Sheldon KM, Lyubomirsky S. Achieving sustainable new happiness: prospects, practices, and prescriptions. : Linley PA, Joseph S, Positive Psychology in Practice. Hoboken, NJ: John Wiley & Sons; 2004:127–145 [ Google Scholar ]
• 54. Nes RB, Roysamb E, Tambs K, Harris JR, Reichborn-Kjennerud T. Subjective well-being: genetic and environmental contributions to stability and change. Psychol Med. 2006;36(7):1033–1042 [ DOI ] [ PubMed ] [ Google Scholar ]
• 55. Schnittker J. Happiness and success: genes, families, and the psychological effects of socioeconomic position and social support. Am J Sociol. 2008;114(suppl):S233–S259 [ DOI ] [ PubMed ] [ Google Scholar ]
• 56. Emmons RA, McCullough ME. Counting blessings versus burdens: an experimental investigation of gratitude and subjective well-being in daily life. J Pers Soc Psychol. 2003;84(2):377–389 [ DOI ] [ PubMed ] [ Google Scholar ]
• 57. Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983; 51(3):390–395 [ DOI ] [ PubMed ] [ Google Scholar ]
• 58. Kaiser Permanente “Thrive” campaign. Available at: http://ckp.kaiserpermanente.org/newsroom/national/archive/nat_050722_newthrive.html . Accessed November 19, 2009
• 59. Executive Summary: CDC Advisory Committee to the Director Meeting. May 1, 2008. Available at: http://www.cdc.gov/about/advisory/pdf/ACDExecutiveSummaryReportJune30.pdf . Accessed March 31, 2011.
• 60. Masten AS, Reed MJ. Resilience in development. : Snyder CR, Lopez SJ, Handbook of Positive Psychology. New York, NY: Oxford University Press; 2005:74–88 [ Google Scholar ]
• 61. Yates TM, Masten AS. Fostering the future: resilience theory and the practice of positive psychology. : Linley AP, Joseph S, Positive Psychology in Practice. Hoboken, NJ: John Wiley & Sons; 2004:521–539 [ Google Scholar ]
• 62. Administration on Aging Nutrition Services (OAA Title III C). Congregate nutrition services. Available at: http://www.aoa.gov/AoARoot/AoA_Programs/HCLTC/Nutrition_Services/index.aspx#congregate . Accessed December 12, 2009
• 63. Seligman MEP. Learned Optimism: How To Change Your Mind and Your Life. New York, NY: Pocket Books; 1998 [ Google Scholar ]
• 64. Reivich K, Shatte A. The Resilience Factor. New York, NY: Broadway Books; 2002 [ Google Scholar ]
• 65. Buchanan GM, Seligman MEP. Explanatory Style. Hillsdale, NJ: Erlbaum; 1995 [ Google Scholar ]
• 66. Buchanan GM. Explanatory style and coronary heart disease. : Buchanan GM, Seligman MEP, Explanatory Style. Hillsdale, NJ: Erlbaum; 1995:225–232 [ Google Scholar ]
• 67. Peterson C. Explanatory style as a risk factor for illness. Cognit Ther Res. 1988;12(2):119–132 [ Google Scholar ]
• 68. Lorig K, Holman H, Sobel D, et al. Living a Healthy Life With Chronic Conditions. Boulder, CO: Bull Publishing; 2000 [ Google Scholar ]
• 69. Seligman MEP, Schulman P, DeRubeis RJ. The prevention of depression and anxiety. Prev Treat. 1999;2(8). [ Google Scholar ]
• 70. Seligman MEP, Ernst RM, Gillham J, Reivich K, Linkins M. Positive education: positive psychology and classroom interventions. Oxford Rev Educ. 2009;35(3):293–311 [ Google Scholar ]
• 71. Penn Resiliency Program Curriculum. Available at: http://www.ppc.sas.upenn.edu/prpsum.htm . Accessed December 3, 2009.
• 72. Gillham JE, Reivich KJ, Jaycox LH, Seligman MEP. Prevention of depressive symptoms in schoolchildren: two year follow up. Psychol Sci. 1995;6(6):343–462 [ Google Scholar ]
• 73. Cutuli JJ, Chaplin TM, Gillham JE, Reivich KJ, Seligman MEP. Preventing co-occurring depression symptoms in adolescents with conduct problems: The Penn Resiliency Program. Ann N Y Acad Sci. 2006;1094:282–286 [ DOI ] [ PubMed ] [ Google Scholar ]
• 74. Brunwasser SM, Gillham JE, Kim ES. A meta-analytic review of the Penn Resiliency Program's effect on depressive symptoms. J Consult Clin Psychol. 2009;77(6):1042–1054 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 75. US Army Comprehensive soldier fitness. Available at: http://csf.army.mil . Accessed March 31, 2011
• 76. Schneider SL. In search of realistic optimism. Am Psychol. 2001;56(3):250–263 [ DOI ] [ PubMed ] [ Google Scholar ]
• 77. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC; American Psychiatric Association; 1994 [ Google Scholar ]
• 78. Sheldon KM, King L. Why positive psychology is necessary. Am Psychol. 2001;56(3):216–217 [ PubMed ] [ Google Scholar ]
• 79. Peterson C, Seligman MEP. Character Strengths and Virtues: A Classification and Handbook. Washington, DC: American Psychological Association; 2004 [ Google Scholar ]
• 80. Park N, Peterson C. The values in action inventory of character strengths for youth. : Moore KA, Lippman LH, What Do Children Need to Flourish? Conceptualizing and Measuring Indicators of Positive Development. New York, NY: Springer; 2005:13–23 [ Google Scholar ]
• 81. Peterson C, Park N. Classification and measurement of character strengths. Implications for practice. : Linley PA, Joseph S, Positive Psychology in Practice. Hoboken, NJ: John Wiley & Sons; 2004:433–446 [ Google Scholar ]
• 82. Otake K, Shimai S, Ikemi A, Utsuki N, Peterson C, Seligman MEP. Development of the Japanese version of the Values in Action Inventory of Strengths [in Japanese]. Shinrigaku Kenkyu. 2005;76(5):461–467 [ DOI ] [ PubMed ] [ Google Scholar ]
• 83. Park N, Peterson C. Moral competence and character strengths among adolescents: the development and validation of the Values in Action Inventory of Strengths for Youth. J Adolesc. 2006;29(6):891–909 [ DOI ] [ PubMed ] [ Google Scholar ]
• 84. University of Pennsylvania Authentic happiness. Available at: http://www.authentichappiness.org . Accessed March 31, 2011
• 85. Hodges TD, Clifton DO. Strengths-based development in practice. : Linley PA, Joseph S, Positive Psychology in Practice. Hoboken, NJ: John Wiley & Sons; 2004:256–268 [ Google Scholar ]
• 86. Ma M, Kibler JL, Dollar KM, et al. The relationship of character strengths to sexual behaviors and related risks among African American adolescents. Int J Behav Med. 2008;15(4):319–327 [ DOI ] [ PubMed ] [ Google Scholar ]
• 87. Lyubomirsky S, Sheldon KM, Schkade D. Pursuing happiness: the architecture of sustainable change. Rev Gen Psychol. 2005;9(2):111–131 [ Google Scholar ]
• 88. Emmons RA, Crumpler CA. Gratitude as human strength: appraising the evidence. J Soc Clin Psychol. 2000;19(1):56–69 [ Google Scholar ]
• 89. Wood AM, Joseph S, Lloyd J, Atkins S. Gratitude influences sleep through the mechanism of pre-sleep cognitions. J Psychosom Res. 2009;66(1):43–48 [ DOI ] [ PubMed ] [ Google Scholar ]
• 90. Bono G, Emmons RA, McCullough ME. Gratitude in practice and the practice of gratitude. : Linley PA, Joseph S, Positive Psychology in Practice. Hoboken, NJ: John Wiley & Sons; 2004:464–481 [ Google Scholar ]
• 91. Otake K, Shimai S, Tanaka-Matsumi J, Otsui K, Fredrickson BL. Happy people become happier through kindness: a counting kindness intervention. J Happiness Stud. 2006;7(3):361–375 [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 92. Cooperrider DL, Whitney D, Stavros JM. Appreciative Inquiry Handbook. 2nd ed Brunswick, OH: Crown Custom Publishing; 2003 [ Google Scholar ]
• 93. Ludema JD, Whitney D, Mohr BJ, et al. The Appreciate Inquiry Summit. San Francisco, CA: Berrett-Koehler Publishers; 2003 [ Google Scholar ]
• 94. Wright M, Baker A. The effects of appreciative inquiry interviews on staff in the UK National Health Service. Intl J Hlth Care Qual Assur Inc Leadersh Health Serv. 2005;18(1):41–61 [ DOI ] [ PubMed ] [ Google Scholar ]
• 95. Moody RC, Horton-Deutsch S, Pesut DJ. Appreciative inquiry for leading in complex systems: supporting the transformation of academic nursing culture. J Nurs Educ. 2007;46(7):319–324 [ DOI ] [ PubMed ] [ Google Scholar ]
• 96. Cowling WR. Pattern, participation, praxis and power in unitary appreciative inquiry. ANS Adv Nurs Sci. 2004;27(3):202–214 [ DOI ] [ PubMed ] [ Google Scholar ]
• 97. Shendell-Falik N, Feinson M, Mohr BJ. Enhancing patient safety: improving the patient handoff process through appreciative inquiry. J Nurs Adm. 2007;37(2):95–104 [ DOI ] [ PubMed ] [ Google Scholar ]
• 98. Rushing AM. The unitary life pattern of persons experiencing serenity in recovery from alcohol and drug addiction. ANS Adv Nurs Sci. 2008;31(3):198–210 [ DOI ] [ PubMed ] [ Google Scholar ]
• 99. Carter B, Cummings J, Cooper L. An exploration of best practice in multi-agency working and the experiences of families of children with complex health needs. What works well and what needs to be done to improve practice for the future. J Clin Nurs. 2007;16(3):527–539 [ DOI ] [ PubMed ] [ Google Scholar ]
• 100. Donovan RJ, Henley N, Jalleh G, Silburn SR, Zubrick SR, Williams A. People's beliefs about factors contributing to mental health: implications for mental health promotion. Health Promot J Austr. 2007;18(1):50–56 [ DOI ] [ PubMed ] [ Google Scholar ]
• 101. van Wijk CH, Waters AH. Positive psychology made practical: a case with naval specialists. Mil Med. 2008;173(5):488–492 [ DOI ] [ PubMed ] [ Google Scholar ]
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• Published: 06 August 2021

Mindfulness-based positive psychology interventions: a systematic review

• Joshua George Allen   ORCID: orcid.org/0000-0001-9662-9863 1 ,
• John Romate   ORCID: orcid.org/0000-0003-0487-7849 1 &
• Eslavath Rajkumar   ORCID: orcid.org/0000-0002-3012-0391 1  

BMC Psychology volume  9 , Article number:  116 ( 2021 ) Cite this article

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There are hundreds of mindfulness-based interventions in the form of structured and unstructured therapies, trainings, and meditation programs, mostly utilized in a clinical rather than a well-being perspective. The number of empirical studies on positive potentials of mindfulness is comparatively less, and their known status in academia is ambiguous. Hence, the current paper aimed to review the studies where mindfulness-based interventions had integrated positive psychology variables, in order to produce positive functioning.

Data were obtained from the databases of PubMed, Scopus, and PsycNet and manual search in Google Scholar. From the 3831 articles, irrelevant or inaccessible studies were eliminated, reducing the number of final articles chosen for review to 21. Interventions that contribute to enhancement of eudaimonia, hedonia, and other positive variables are discussed.

Findings include the potential positive qualities of MBIs in producing specific positive outcomes within limited circumstances, and ascendancy of hedonia and other positive variables over eudaimonic enhancement.

In conclusion, exigency of modifications in the existing MBIs to bring about exclusively positive outcomes was identified, and observed the necessity of novel interventions for eudaimonic enhancement and elevation of hedonia in a comprehensive manner.

Peer Review reports

Background of the study

Mindfulness, a practice of conscious non-judgmental awareness to the present, emerged in the Indian subcontinent approximately 2500 years ago [ 1 ]. Around four decades back, with the pioneering works of Kabat Zinn who had incorporated mindfulness into psychotherapy, the scientific application of mindfulness for health and well-being for specific contextual needs had started [ 2 ]. Since then and particularly in the last decade, academic interest in the area of mindfulness has been increasing and the applicability of mindfulness in various facets of life is also getting attention [ 3 , 4 , 5 , 6 , 7 , 8 ]. Most of the accessible Mindfulness-Based Interventions (MBIs) are either standalone therapies or facilitating therapies for various clinical disorders and problems. Although mindfulness contributes immensely to clinical psychology, the concept of mindfulness has a broader and vaster meaning, beyond clinical symptom reduction and toward positive human functioning and flourishing. In recent years, Positive Psychology Interventions (PPIs) that integrate mindfulness elements have shown some promising outcomes [ 1 , 9 , 10 ]. Still, there is a significant lack of clarity in the implementation of Mindfulness-Based Positive Psychology Interventions (MPIs) and their impact on positive human functioning. Hence the current study aims to find and analyze the mindfulness-based interventions from the existing literature which have also shown potentials to be a positive psychology intervention.

Beginning from Mindfulness-Based Stress Reduction (MBSR) proposed by Kabat Zinn in the 1970s, MBIs are mostly used in the clinical settings for managing disorders and supporting prognosis of disorders and diseases. As an attempt to balance this reductionist deficit-model of health, the well-being outcomes of MBIs are also studied, especially in recent years. A positive psychology intervention is defined as “an intervention, therapy, or activity, primarily aimed at increasing positive feelings, positive behaviors, or positive cognitions, as opposed to ameliorating pathology or fixing negative thoughts or maladaptive behavior patterns” [ 12 ]. In this context, an MPI is “a mindfulness-based intervention with the primary aim to enhance positive human functioning”. PPIs not only exert impact on positive variables, but also are effective among clinical populations—as standalone therapies or facilitating interventions—such as the individuals suffering from depression [ 11 , 12 ], affective disorders [ 13 ], generalized anxiety disorder [ 14 ], and eating disorders [ 15 ]. Apart from that, regardless of the nature of population, PPIs have the potential to enhance positive cognition, positive affect, positive behavior, and overall positive functioning and experiences. Integrating positive psychology with mindfulness, or accommodating mindfulness elements in psychotherapy, a number of MBIs are developed, however, the existing literature is insufficient to articulate the quality and quantity of the researches on MPIs. In order to fill this gap, research on the current status of MPIs is warranted.

Furthermore, well-being mainly consists of hedonia and eudaimonia, two highly correlated but distinct forms of well-being, with different characteristics [ 16 , 17 ]. Though they are not mutually exclusive or antagonistic to each other, their nature, intensity, and patterns of expression are singular. This paper attempts to consolidate major mindfulness-based interventions devised for the enhancement of positive functioning beyond clinical symptom reduction, with a given priority to determine the status of MPIs for eudaimonic enhancement. Secondary importance is given to MPIs or MBIs for hedonic well-being and other positive psychology variables such as hope, happiness, resilience, gratitude, flow, compassion, and improved psychological performance. Studies, where a positive psychology variable was just one among three or more dependent variables, were excluded due to their orientation toward the deficit model rather than to positive psychology.

The positive potentials of mindfulness

Eudaimonic enhancement.

Eudaimonia is originally a Greek term that can be translated from a subjective perspective as “happiness”, and from an objective point of view, as “flourishing” [ 18 ]. Broadly, eudaimonia is “the pursuit, manifestation, and/or experience of virtue, personal growth, self-actualization, flourishing, excellence, and meaning” [ 19 ]. The “mindfulness-to-meaning theory” proposed by Garland et al. [ 20 ], advocates that mindfulness broadens the awareness spectrum resulting in cognitive-reappraisal of events to include the positive possibilities of specific instances, that enable the individual to perceive the meaning and purpose of life experiences. The cumulative effects of meaningful positive experiences bring about eudaimonic well-being. And unlike hedonia, eudaimonia will gradually expand on its own without the support of any external agencies, and its possibilities are literally infinite. This nature of eudaimonia is elucidated by the concepts of “eudaimonic staircase” [ 21 ] and the “upside spiral of positive emotions” described in the broaden-and-build theory [ 22 ]. Thus, this review is expected to be a beneficial contribution to the existing scientific knowledge on the role of MBIs in utilizing the eudaimonic-enhancement capability of mindfulness. In addition, recognition of the current utility spectrum of MBIs would support better usage of those MBIs as eudaimonic enhancement tools, or signify the need of further explorations on MBIs for eudaimonic enhancement.

Hedonic enhancement

Hedonia or hedonic well-being shall be defined as “the pursuit and/or experience of pleasure, enjoyment, comfort, and reduced pain” [ 19 ]. Since pain reduction is an element of hedonia, all kinds of psychotherapies are, in a sense, involved in the augmentation of hedonic well-being. Along with eudaimonia, hedonia contributes to subjective well-being [ 18 ]. The efficacy of MBIs is associated with fulfillment of hedonic needs. Some studies have explored the relationship between mindfulness and hedonic well-being and confirmed the assumption that mindfulness functions in direct and indirect ways to induce pleasure and reduce pain [ 23 , 24 ]. Other than clinical symptom management, hedonia and its components can be induced by MBIs, independently as well as in combination with other positive variables. Enhancement of enjoyment [ 25 ], happiness [ 26 ], and positive affect [ 27 , 28 ] are a few examples. Although not always directly stated, improved hedonia—reduced pain and discomfort or improved pleasure and comfort—had been described in clinical literature where MBIs are utilized for therapeutic purpose. The existing literature recognizes the hedonic enhancement quality of mindfulness, but they are not being studied comprehensively. Hence, this review gives auxiliary importance to narrate the MBIs that produced hedonic well-being.

Increasing other positive outcomes

Theoretically and empirically, mindfulness is found to be connected with a number of positive psychology variables. Different MBIs often focus on a specific aspect such as compassion, relaxation, and cognitive skills. Literature suggests that MBIs are effectual in generating a number of positive outcomes such as hope [ 29 ], optimism [ 30 , 31 ], prosocial behavior [ 32 ], flow [ 33 ] working memory [ 34 ], and academic performance [ 35 ]. This paper also reviews MBIs that had produced positive outcomes in addition to eudaimonic and hedonic well-being, in expectation of identifying the extent of impact conceivable for an MPI.

Purpose of the study

This paper attempts to present a narrative/descriptive synthesis of the major MBIs with positive potentials. Firstly, it intends to identify standardized or empirically validated MPIs. Secondly, MBIs that produce positive functioning shall be recognized and their efficacy as an MPI will be verified. Further, the MBIs that improve hedonic well-being and/or other positive variables will also be reported. Finally, the study stands to recount the intention of MBIs in eudaimonic enhancement.

Data were drawn from three electronic databases—PubMed, Scopus, and PsycNet—and a manual search in Google Scholar, from the inception to 29 May 2020. Keyword string used for database search was “mindfulness intervention” and filters were “controlled clinical trials” and “randomized controlled trial” in PubMed; “articles” and “psychology” in Scopus; and “articles” in PsycNet.

Eligibility criteria

The inclusion criteria were: (i) studies with the application of mindfulness-based intervention regardless of the population characteristics such as age, gender, and ethnicity; (ii) experimental and quasi-experimental studies that compared the outcomes between individuals administered with and without an MBI; and (iii) studies with positive psychology variables as dependent variables. The exclusion criteria followed to eliminate the articles were: (i) review papers, (ii) medical/ neuropsychological researches, and (iii) studies with positive psychology variables as just one among three or more dependent variables.

Positive psychology outcomes considered included but not limited to general well-being, eudaimonic well-being, hedonic well-being, happiness, hope, grit, loving kindness, gratitude, empathy, and flourishing. Studies where positive psychology variable was just one among the three or more dependent variables were excluded. It was because the focus of the current research was to find the MBIs that produced positive psychology variables as outcomes (or positive outcomes); and due to the dichotomous nature of many psychological variables, they have a positive and negative continuum which can be reported as the presence or absence of either positive or negative end. If three or more dependent variables are assessing clinical or non-positive conditions, it is highly likely that the one positive variable among these is the absence of a clinical condition rather than a positive psychology outcome. For instance, well-being is often reported as the absence of a clinical condition such as anxiety or depression. Also, when majority of the outcome measures are related to non-positive variables, the intervention is less likely to be developed for positive impacts. Including such studies would redirect the focus of the study and unnecessarily increase the time, energy, and resources for conducting the research.

Review papers were excluded because the study focused on original researches that reported outcomes of an MBI. Papers on medical/ neuropsychological researches were also excluded because their focus was not identification of positive psychology variables as the outcome measures of MBIs. Rather than the physiological mechanisms behind exposure to an MBI, the current study focused on perceived enhancement of positive psychology variables.

Data collection

A complete database search on PubMed, Scopus, and PsycNet was carried out along with a manual search in Google Scholar (see Fig.  1 ). From the four electronic databases, 5045 articles were found, whose titles and abstracts were transferred to the reference management software Zotero on 29 May 2020. After elimination of duplicates, 3377 articles remained. The first author had screened the articles and removed 3234 articles that did not meet the inclusion criteria, leaving 143 articles for full-text review. In the list of 143 articles two articles were rejected due to unavailability of full-text. Rest of the 141 articles were scrutinized and 120 articles were removed that met the exclusion criteria—being review/meta-analytic papers, medical/ neuropsychological researches, or studies where positive psychology variables were just one among three or more dependent variables. At the first stage of elimination, the third author had verified 30% of the randomly chosen articles, and at the second stage of elimination the second and third authors had randomly chosen 30% of the full-text articles and cross-verified, after which 100% of consensus was confirmed regarding the exclusion and inclusion of the articles. Finally, 21 articles that reported an MBI with an anticipated impact on positive variables were chosen for the review. Risk of bias tool of Cochrane (2019 version) [ 36 ] was used to identify risk of bias of the finally chosen articles. In order to reduce any bias during the process of quality assurance, all of the authors had independently applied the tool among all the chosen studies. Except minor differences of opinion, which were resolved through references to literature and open discussions, no major conflicts had occurred. Studies were found to have low risk or some concerns, and none of the chosen studies had shown high risk.

PRISMA flow diagram [ 65 ]

Among the 21 articles analyzed, 22 studies were identified, out of which two studies consisted of clinical populations and 20 different normal populations. Collectively, these 22 studies had assessed the impact of the intervention on 134 dependent variables, and 105 of these were positive aspects (eudaimonia and related aspects = 65, hedonia and related variables = 8, general well-being = 7, other positive psychology variables = 25). The finally chosen studies showed a high heterogeneity in terms of research designs, types of intervention, and outcome measures, due to which a narrative/ descriptive synthesis of the data was employed. Table 1 shows the list of studies as indicated by the author name(s) and year of publication, subsequent research designs, sample size, intervention, dependent variables, duration of the intervention, the population to whom the intervention was administered, and the major findings related to the intervention. As per the aim of this review, scope of data analysis is limited to identification of interventions as MPIs or MBIs with expected impact on positive variables. The paper describes the results of the studies as it is reported by the authors. There is scope for further studies to verify the efficacy of the interventions and whether they would produce the positive outcomes they intended to generate or capable of generating.

Interventions and procedures

A brief account of the interventions, research design, and procedures are described in this section. Studies are categorized based on the nature of the interventions, aiming to convey better meaning of the elaborate narration. This section aims to identify the MBIs that have the potential to be an MPI. And the next section, ‘Outcomes of MBIs’, deals with categorizing studies based on the intention of the intervention to enhance eudaimonia or hedonia and other positive variables. Here, depending on the nature of the intervention, they are categorized into eight: (1) Psychotherapies, (2) MBIs for children, (3) Mindfulness apps (4) Positive Relationships, (5) Mindful Self Compassion, (6) Loving Kindness Meditation, (7) MBIs that may act as MPIs and (8) MPIs.

Psychotherapies

MBIs are commonly used as therapeutic strategies, even when the positive outcomes are being explored. In such a study, Nyklícek & Kuijpers [ 28 ] had applied the MBSR intervention among distressed adults using a randomized waitlist controlled trial. The study intended to find out if the effect of MBSR on stress, vital exhaustion, positive affect, negative affect, quality of life, mindfulness, and daily mindfulness were mediated by mindfulness. Another research carried out by Amutio et al. [ 37 ] attempted to estimate the effect of MBSR on mindfulness and relaxation states of 42 physicians. The primary aim of the study was to test the efficacy of MBSR in inducing relaxation among professionals from a highly distressing career background. Also, heart rate was included as a dependent variable in order to confirm that MBSR could act as a relaxation method at a physical level as well. Although relaxation is a byproduct of mindfulness, other possible positive outcomes that could have opened ways to enhance human well-being and flourishing, were not the object of focus in this study. In another study, de Vibe et al. [ 38 ] had reported a six-year-long longitudinal study, where the impact of a seven-week abridged MBSR is described. The study illustrates the well-being, coping, and mindfulness of 288 participants. Another popular psychotherapy that makes use of mindfulness is Acceptance and Commitment Therapy (ACT). A guided seven-week internet-delivered Acceptance and Commitment Therapy (iACT) was administered among 68 university students with high distress. The participants’ well-being (psychological, emotional, and social domains), life satisfaction, self-esteem, mindfulness, stress, anxiety, depression, psychological flexibility, and sense of coherence were assessed by eight psychological assessment tools [ 39 ]. Since the study had combined clinical and positive outcome measures and because the interaction among these variables was uncertain, it is safe to refrain from concluding that iACT would be useful as a positive psychology intervention. Mostly, the MBIs with psychotherapeutic properties are predominantly governed by deficit-reduction qualities and the positive outcomes are only consequential.

MBIs for children

Three of the reviewed studies had been conducted among children [ 32 , 40 , 41 ]. Eudaimonic well-being among children is an area in the scientific literature with extremely less empirical information [ 42 ]. And the operational definitions of eudaimonia assessed among children are found to be limited in scope. In a study that attempted to see the impact of an MBI among child population, Huppert & Johnson [ 41 ] had administered four 40 minutes of mindfulness classes, one session per week, to 155 boys belonging to the age group of fourteen and fifteen years. Pre and post-assessments were conducted on their mindfulness, resilience, well-being, and big-five personality variables. In another research, Flook et al. [ 32 ] had observed 68 preschool children who were administered with a 12-week Mindfulness-Based Kindness Curriculum. A randomized waitlist controlled design was employed to obtain the amount of their social competence (a combination of pro-social behavior and emotion regulation), sharing, delay of gratification, cognitive flexibility, inhibitory control, and academic performance. Devcich et al. [ 40 ] had carried out another study where a novel intervention namely “Pause, Breathe, Smile” was tested for its efficacy with an active-controlled pilot design, against an emotional literacy program. Duration for both of the programs was one-hour weekly sessions for eight weeks. The study assessed pre and post scores of 91 school children, on well-being—including hedonia and eudaimonia—and mindfulness. Considering that the target population is children, it is not to be expected to find a concept as complex as eudaimonia to be manipulated or measured effectively, particularly when the interventions do not follow a standardized procedure. Although mindfulness was taught, the studies did not primarily focus on the well-being or other positive functioning of the participants, possibly because of the difficulty in gathering information on positive experiences from children. Hence, the three different interventions adopted here cannot be considered as effective tools for enhancing well-being and flourishing, but they shall be useful tools for specific targeted behavioral modifications and academic performance.

Mindfulness apps

The use of online platforms for counselling and psychotherapy is becoming popular nowadays, especially since the outbreak of covid 19 pandemic in 2020 [ 43 , 44 ]. Not just the reduction of undesirable states of mind, but the enhancement of positive functioning is also getting wide acceptance at a global level [ 45 ]. There are a few commercial mindfulness-based applications accessible though smart phones that were also empirically validated through scientific researches. In this review of MBIs, two of the studies chosen had implemented two apps—“Calm” and “Headspace” to explore its impact on health and well-being. Bhayee et al. [ 46 ] had tested the therapeutic efficacy of a commercial neurofeedback assisted, technology-supported mindfulness training (NtsMT). The experimental group was exposed to the “Calm” app in a pre-planned manner with recorded instructions. They have used a randomized active-control trial among 26 participants. Electroencephalogram (EEG) was used as the neurofeedback mechanism, and the psychological variables assessed were attention and well-being. Champion et al. [ 47 ] had conducted another research using a self-guided mindfulness meditation app, “Headspace”. The introductory program of the Headspace, “Foundation 1 to 3” with 30 sessions (10 at each level), was administered to the participants. The minimum duration of a session was 10 min, and there was an option to increase the duration up to 15 and 20 min for second and third levels respectively. They have assessed the life satisfaction, stress, resilience, social impairment, depression, anxiety, hypochondriasis, and enjoyment and experience of 62 participants. Both of these studies had apparently anticipated reduced clinical symptoms from the interventions, and the range of positive outcomes assessed were too narrow, suggesting that the intended use of these apps, in the concerned studies, was not primarily positive functioning.

Positive relationships

Positive relationships is a component of eudaimonic well-being. Three studies selected for the review had utilized three different interventions with the principal aim of improving relationships. Carson et al. [ 48 ] had tested the effect of a novel intervention, Mindfulness-Based Relationship Enhancement (MBRE), on relationship satisfaction, relatedness, autonomy, interpersonal closeness, partner acceptance, relationship distress, spirituality, individual relaxation, and psychological distress. They had adopted a randomized waitlist controlled design and the participants were 44 relatively happy and non-distressed couples. Another MBI that aimed at improving ‘positive relationship’ was applied in a study by Coatsworth et al. [ 49 ]. They had tested the efficacy of the Mindfulness-Enhanced Strengthening Families Program (MSFP) against a standard of care condition and control groups. They have adopted a randomized controlled comparative effectiveness study design with 432 families. The intervention intended to impact interpersonal mindfulness in parenting, parent-youth relationship, youth behavior management, and parent well-being. MSFP was an adapted intervention meant to be a preventive measure to protect adolescents from substance use and behavior problems. With the added element of mindfulness in the adapted version of the intervention, some positive outcomes were also anticipated which were included as dependent variables. Kappen et al. [ 50 ] had conducted another study on positive relationship , using a brief 12-day online mindfulness program. Intended outcomes of this intervention were elevated relationship satisfaction, partner acceptance, and trait mindfulness. Adults who had been in a romantic relationship for at least one year were recruited through social networking sites. Despite being context-specific and not focusing on relationship enhancement in an exhaustive way, these interventions definitely throw some light on the status of MBIs that are considered to be relationship enhancers. Specifically, MBRE, MSFP, and the 12-day online mindfulness program are apparently effective to improve quality of relationships at specific contexts. Since these interventions are designed for healthier relationship between specific target populations, such as couples, the same interventions will not be sufficient to improve relationship quality in another situation.

Mindful self compassion (MSC)

MSC, an intervention developed by Neff and Germer [ 51 ], intends to build self compassion in both normal and clinical populations. It is fundamentally a mindfulness-based positive psychology intervention, which gives priority to self-compassion and secondary importance to mindfulness. Other outcomes resultant from compassion and mindfulness shall also be expected from MSC, but its focus is not shared with any further components of well-being or other positive psychology variables. The current review found two papers where three studies that employed MSC were reported. Neff & Germer [ 51 ] had performed a pilot study and another randomized waitlist controlled trial to examine the effect of the Mindful Self Compassion (MSC) program. The intervention was for eight weeks, one two-hour session per week. They have studied the impact of the intervention on self-compassion, mindfulness, connectedness, happiness, life satisfaction, depression, anxiety, and stress in the first study and have added two more dependent variables in the second study, which are avoidance, and compassion for others. In another study, Yela et al. [ 52 ] had explored the impact of a Mindful Self-Compassion (MSC) program on self-compassion, mindfulness, psychological well-being, anxiety, and depression among 61 psychology trainees. The intervention lasted for eight weeks, with a 2.5-hour session weekly. The MSC interventions applied in these three studies have acted as psychological tools to improve specific elements of eudaimonic and hedonic well-being, along with other factors. The positive impacts of the interventions were looked upon from the point of view of ‘improved well-being through improved mental health’ rather than enhancement of well-being, happiness, flourishing, or meaning in life. It is difficult to conclude whether MSC was effectively established as an MPI through the aforementioned studies, considering the nature of MPI as an intervention with primary focus on positive outcomes. Nevertheless, the study results indeed emphasize the positive potentials of MSC.

Loving kindness meditation (LKM)

LKM is a kind of Buddhist meditation that intends to induce “a feeling of warmth and caring for self and others” [ 53 ]. Among the 22 studies reviewed, two studies had incorporated interventions that utilized LKM. Fredrickson et al. [ 53 ], in their study, recruited 139 working adults into experimental and waitlist control groups and the former was administered with 13 measures that assessed 15 variables—mindfulness, agency thinking, pathway thinking, savoring beliefs, optimism, ego resilience, psychological well-being, dyadic adjustment, positive relations, illness symptoms, sleep quality, satisfaction with life, depression, differential emotions, and emotion experiences. LKM was provided to the former group that extended for seven weeks with one hour weekly sessions. In a different study, Sorensen et al. [ 54 ] had investigated the effects of a novel intervention called ‘Convergence’ that combined LKM and classic guitar music. The two active-controlled conditions were given either music alone or meditation alone. All three conditions were prolonged for three weeks, providing one session per week, and the participants were assessed for mindfulness, self-compassion, fears of compassion, stress and anxiety, and mental well-being. Both of these researches focused less on the positive qualities of the intervention. LKM is a meditation practice that involves mindfulness elements but with an additional intentional focus on warm and tender feelings toward oneself and the others. LKM strives to instill an attitude of loving-kindness and do not attempts to enhance any other psychological properties directly. But the study results indicate that it is sufficient to improve specific aspects of hedonic and eudaimonic well-being.

MBIs that may act as MPIs

Positive psychology is relatively young and the number of studies is not yet comparable with that of clinical psychology and other deficit-focused fields of psychology. But it is a rapidly developing area that overlaps with the studies on mindfulness. There were three researches in this review where the positive psychological variables were looked into more vigorously. One of these was reported by Rodríguez-Carvajal et al. [ 55 ] where a non-randomized controlled study was used among 73 participants to substantiate the effect of a three-week Mindfulness Integrative Model (MIM) on mindfulness, self-compassion, and positive states of mind. In another instance, Pogrebtsova et al. [ 56 ] had studied the impact of a five-day combined mindful-reappraisal intervention on students’ positive and negative experiences, positive re-appraisal, decentering, curiosity, and optimism. The sample consisted of 106 participants where 36 were in the experimental group, which was compared against a ‘standard of care’ condition and active control group. The third study was carried out by Vich et al. [ 57 ] where a modified intervention, ‘Relational Mindfulness Training’ (RMT) was administered to 75 management students, and their self-compassion, compassion, stress, mindfulness, and happiness were measured. Despite a larger part of well-being aspects being still unexplored, the positive potentials of MBIs are well-documented in these researches. Further studies shall unravel the actual positive qualities of these interventions.

Mindfulness-based positive psychology interventions (MPIs)

It sounds as if two studies had explored the exponential positive power of MBIs. Ivtzan et al. [ 58 ] had studied the impact of a novel MPI, eight-week online ‘Positive Mindfulness Program’ (PMP) on eudaimonic and hedonic well-being, stress, depression, mindfulness, gratitude, self-compassion, autonomy component of psychological well-being scale, self-efficacy, meaning in life, compassion for others, and appreciation for the present moment, among 168 adults from 20 different countries. They have used a randomized waitlist controlled trial with pre, post, and one-month follow up data. Here, PMP had tested both clinical and positive outcomes, but basically it is an intervention developed to improve well-being through nine specific components –(i) positive emotions, (ii) self-compassion, (iii) well-being (happiness), (iv) autonomy, (v) mindfulness, (vi) self-efficacy (strengths), (vii) meaning, (viii) compassion, and (ix) engagement (savoring)’ [ 1 ]. In a different study by Smith et al. [ 59 ], 31 meditating adults were assessed for quality of life, subjective well-being, well-being, valuing, psychological flexibility, mindfulness, and cognitive fusion. The experimental group consisted of 17 individuals who had practiced Dharma in Daily Life (DIDL) for 30 minutes per day, extending six days a week, for two years course period and six months follow-up period, and possibly beyond. DIDL indeed had undeniable positive impact, but the intensity and duration raises questions about its feasibility as a common MPI. Nevertheless, both PMP and DIDL show promising utility of MPIs for enhancement of eudaimonia, hedonia, and other specific positive variables.

Outcomes of MBIs

The reviewed studies vary greatly based on research designs, outcome measures, intensity and structure of interventions, and analytical methods adopted. Hence, due to this high heterogeneity, it was only possible to narrate a peripheral report of outcomes. Depending on the effect sizes of outcome measures, there is an extended scope for further studies which surpass the objectives of the current review. Here, based on the intended positive outcomes of the interventions, studies are categorized into: (1) Enhancement of eudaimonia, (2) Enhancement of hedonia, and (3) Enhancement of other positive variables.

Enhancement of eudaimonia

In a randomized controlled efficacy trial, Rasanen et al. [ 39 ] found that there is a significant increase in well-being, life satisfaction, and mindfulness among the participants who had exposed to the iACT. They had also reported less stress and depression. These effects were intact in a 12-month follow-up as well. The study results show the plausible impact of an MBI on well-being, life satisfaction, and mindfulness, that shall contribute to a sense of purposeful living, one of the different components of eudaimonia.

Devcich et al. [ 40 ] had administered a mindfulness-based intervention, ‘Pause, Breathe, Smile’, to 45 school children as part of a research. Compared to an active control group, the former children had shown higher mindfulness and well-being (hedonia, eudaimonia, and socially desirable responsibility). The MBI ‘Pause, Breathe, Smile’ is likely to contribute to the eudaimonic well-being of children, not in a comprehensive way but to a limited extent.

Carson et al. [ 48 ] had observed the significant positive impact of Mindfulness-Based Relationship Enhancement on relationship functioning and well-being of couples, even when the couples were relatively happy and non-distressed at the baseline level. They had received results that supported the beneficial effect of the MBI on all dependent variables that was maintained at a three-month follow-up. In their study, Coatsworth et al. [ 49 ] had applied MSFP for strengthening four conditions related to family functioning. They have concluded that MSFP improved interpersonal mindfulness in parenting, parent-youth relationships, youth behavior management, and parent well-being. Kappen et al. [ 50 ] reported that, after a 12-day online mindfulness practice, 56 participants with lower baseline mindfulness reported higher relationship satisfaction and partner acceptance compared to the control group. Otherwise, both the groups, regardless of the administration of mindfulness practice or psycho-education, showed no significant difference in the aforementioned variables. In these studies, three different interventions indicate the possible usage of MBIs for ‘positive relationships’, a component of eudaimonic well-being.

Yela et al. [ 52 ] had studied the effects of MSC program and found that it has a significant impact on self-compassion, mindfulness, and psychological well-being (PWB) or eudaimonia. Despite focusing on the enhancement of compassion alone, the intervention proved to be a potential MPI for eudaimonic enhancement.

Ivtzan et al. [ 58 ] had tested the impact of PMP, on 11 psychological variables. The result indicated that there was a significant difference between the experimental and control groups on the basis of their scores of all the 11 dependent variables, including eudaimonic and hedonic well-being, mindfulness, meaning in life, compassion, and gratitude. PMP focuses on enhancement of both hedonic and eudaimonic well-being and accounts promising outcomes as an MPI for eudaimonic enhancement.

Enhancement of hedonia

In a field experimental study, Fredrickson et al. [ 53 ] found that the practice of LKM improved participants’ positive emotions (amusement, awe, contentment, joy, gratitude, hope, interest, love, and pride, collectively), and its effect expanded beyond the duration of meditation and cumulated overtime. Pogrebtsova et al. [ 56 ] had administered a five-day mindful reappraisal intervention to 36 participants and acquired results that suggest a decrease in negative affect and increase in positive affect toward the end of the intervention, compared to the scores of an active control and a standard of care conditions. Smith et al. [ 59 ] elucidated an instance when 17 participants were studied against a control group of 14 after getting exposed to DIDL intervention. It was stated that the experimental group, post-intervention, reported higher subjective well-being, well-being, mindfulness, psychological flexibility, and valuing. Nyklicek & Kuijpers [ 28 ] had narrated the impact of MBSR on stress, vital exhaustion, positive affect, quality of life, and mindfulness, in a randomized controlled trial. Compared to the control group, individuals exposed to the MBSR reported decreased stress and vital exhaustion, and increased positive affect, quality of life, and mindfulness. In a study using MIM, Rodriguez-Carvajal et al. [ 55 ] had found that the intervention enhanced mindfulness, self-compassion, and positive mental states.

The interventions mentioned above are valuable in improving specific aspects of hedonic well-being—either by reducing negative experiences or by improving pleasure and joy.

Enhancement of other positive variables

Flook et al. [ 32 ] had obtained evidence for a 12-week mindfulness-based Kindness Curriculum being effective in improving social competence, including pro-social behavior and emotion regulation, of pre-school children. It had also improved academic performance, tendency to delay gratification, and cognitive flexibility. In a longitudinal study, de Vibe et al. [ 38 ] reported that after a six-year follow-up, the participants who had undergone a 7-week abridged MBSR scored higher in well-being, mindfulness, and problem-focused coping that was a predictor of higher well-being. They had also revealed deteriorated avoidance-focused coping. The results were present even among the participants with low adherence to the regular practice of MBSR. Amutio et al. [ 37 ] have also described the effect of MBSR on well-being and related variables. At the end of the intervention period, participants in the experimental group scored significantly higher in mindfulness and relaxation. After a 10-month maintenance phase, their already reported positive outcomes were found to have increased even higher, particularly the scores on mindfulness, and all four dimensions of relaxation state—mindfulness, positive energy, transcendence, and relaxation. Bhayee et al. [ 46 ], using the app 'Calm', had studied the impact of an NtsMT on attention and well-being. The result suggested a moderate effect of mindfulness on attention and well-being while previous literature had a different say on its effect size. The reason shall be attributed to the delivery mode of the intervention, its duration, or both. Sorensen et al. [ 54 ] had introduced a novel intervention, Convergence , that was tested for its efficacy in comparison with an LKM-only group and a music-only group. The results indicated that all these three conditions improved mindfulness, self compassion, and well-being with small effect sizes. A study conducted by Huppert & Johnson [ 41 ] revealed high positive association between the time spent for mindfulness practice outside the intervention period and the amount of mindfulness and well-being. Other than that, between control and experimental groups, no significant differences were observed. The effect of RMT on compassion, stress, and mindfulness were assessed by Vich et al. [ 57 ]. Their study results outlined that RMT has a significant impact on self-compassion, stress, and mindfulness in the long run. RMT had an impact on compassion, and subjective happiness for a short time, but failed to sustain it over time. In a pilot randomized controlled trial, Champion et al. [ 47 ] had received the effect of the use of a mindfulness meditation app ‘Headspace’ on life satisfaction, stress, and resilience. Highest improvement was on 10 th session, that dropped moderately by the last and 30th session. Through two subsequent studies, Neff & Germer [ 51 ] obtained evidences for the impact of MSC on enhanced mindfulness, self-compassion and well-being.

MBIs as mindfulness-based positive psychology interventions (MPIs)

In the current systematic review, 21 papers were reviewed that described 22 studies on the impact of MBIs over positive human functioning, with prime importance given to eudaimonic well-being and secondary preference given to hedonic and other positive psychology variables. The latter was given secondary focus as hedonic well-being or the tendency to seek pleasure and avoid pain is mostly associated with clinical symptom reduction and temporary pleasurable experiences, rather than well-being and flourishing. Most of the MBIs reviewed were developed for specific needs not comprehensively focusing on either eudaimonia or hedonia and other positive psychology variables. Interventions administered among children were reported by three studies [ 32 , 40 , 41 ] and all these three have focused on a few specific positive psychology variables which cannot be attributed to an overall enhancement in eudaimonic or hedonic well-being. Three studies [ 48 , 49 , 50 ] have focused on a dimension of eudaimonic well-being—positive relationships. One of these is an adapted preventive intervention for adolescent substance use and problem behavior, and could not be considered as an MPI. The target population for six studies was college/university students [ 38 , 39 , 47 , 52 , 56 , 57 ]. One of these has chosen only distressed students and none of the studies focused entirely on well-being. Ten studies had recruited the general adult population through online or regular modes. Some studies advertised for volunteers as participants and some have recruited participants from institutions under different conditions. Most of the studies offered remunerations at various points. None of these studies employed interventions for enhancement of well-being with prime importance, and the positive impact of all of these MBIs was limited, focusing on specific aspects like self-compassion, mindfulness, or resilience. Hence, without ignoring the positive potential of these MBIs, it is required to point out the need for exploring positive outcomes of MBIs more extensively, and modify the existing interventions if required, to incorporate facilities to enhance positive outcomes.

Limitations

The review was restricted to three databases and manual search, and the possibility of unintentional exclusion of relevant articles indexed in other databases cannot be ignored. It is also possible that some of the excluded articles that primarily focus on clinical variables had reported the positive potentials of those clinical interventions. Though not high, there is a risk of bias in the cumulative result. And high heterogeneity of reviewed studies restricted the current research to opt for a systematic review rather than meta-analysis.

Conclusions

The current review has identified the major studies where MBIs were applied and its impact on positive human functioning assessed. The nature, pattern, duration, and focal area of interventions varied greatly and mostly centered around a few specific positive variables rather than overall well-being and flourishing. Application of MBIs for hedonic and other positive variables is found to be more frequent than the usage of MBIs for eudaimonic enhancement. This was not concluded from just the review of the final 21 articles, but from the entire process of finalizing those studies. This is consistent with the statement of Deci & Ryan [ 60 ] who had noted that the number of studies on hedonia greatly exceeds than that on eudaimonia. Hedonic well-being was closely associated with clinical symptom reduction instead of increment in the experience of perceived pleasure. Most of the MBIs applied with expected positive outcomes were context-specific or limited in the scope of applicability. The review was futile in finding any singularly positive-psychology oriented interventions, but a few of the interventions show powerful utility as an MBI that could enhance specific positive variables. Further empirical explorations shall reveal the potency of these MBIs as mindfulness-based positive psychology interventions. Modifications in the structure and functions to be more inclusive of contexts and populations would yield better positive outcomes of the existing MBIs. Also, MBIs that aimed at catering the needs of the recipients based on factors such as culture, ethnicity, and gender would result in highly effective MPIs. From the review, it could also be concluded that it is imperative to develop interventions with sole focus on enhancement of positive potentials, especially eudaimonic enhancement.

Study results point out that physical pleasures derived out of hedonia are not sufficient for the experience of well-being [ 61 , 62 , 63 ]. Keyes & Annas [ 64 ] pointed out the gulf between individuals with high hedonic well-being (48.5%) and their flourishing (18%). This explains the severe eudaimonic deficiency that contributes to the lack of flourishing. And in some other personal or social situations where hedonia can contribute little to a person’s well-being—such as chronic illnesses, physical or psychological pain, financial insecurity, childlessness, bereavement, or social/political unrest—eudaimonia is inevitable to maintain general well-being, happiness, contentment, and a sense of meaning and purpose in life. Eudaimonia apparently buffers against possible psychological harm also [ 64 ]. Hence it demands explorations in the direction of eudaimonic enhancement across different populations, cultures, and contexts. Unfortunately, few researches have addressed this issue so far and eudaimonic enhancement still remains a neglected area within applied positive psychology. Considering the paucity of MPIs exclusively for eudaimonic enhancement, it is recommended that immediate further actions are essential to develop, validate, and avail the same, among both clinical and non-clinical populations. In conclusion, the current study has reviewed the major studies where the MBIs are used for enhancement of eudaimonia, hedonia, and other positive psychology variables. It contributes to the existing scientific literature by pointing out the positive potentials of MBIs and the endless possibilities of empirical studies on the application of MPIs. Finally, the review emphasizes the need of future studies paying attention to the utilization of eudaimonic enhancement potential of MPIs along with the focus on enhancement of hedonic and other positive outcomes.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

Mindfulness-Based Intervention

Positive Psychology Intervention

Mindfulness-Based Positive Psychology Intervention

Mindfulness Based Stress Reduction

Internet-delivered Acceptance and Commitment Therapy

Neurofeedback assisted technology supported mindfulness training

Electroencephalogram

Mindfulness-Based Relationship Enhancement

Mindfulness-Enhanced Strengthening Families Program

Mindful Self Compassion

Loving Kindness Meditation

Mindfulness Integrative Model

Relational Mindfulness Training

Positive Mindfulness Program

Dharma in Daily Life

Lomas T, Ivtzan I. Beyond deficit reduction: exploring the positive potentials of mindfulness. In: Shonin E, Gordon WV, Griffiths MD, editors. Mindfulness and buddhist-derived approaches in mental health and addiction. Cham: Springer International Publishing; 2016. pp. 277–95. https://doi.org/10.1007/978-3-319-22255-4_14 .

Kabat-Zinn J. Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. New York, NY: Bantam Dell; 2005.

Toniolo-Barrios M, Pitt L. Mindfulness and the challenges of working from home in times of crisis. Bus Horiz. 2021;64:189–97.

Article   PubMed   Google Scholar  

Stankov U, Filimonau V, Vujičić MD. A mindful shift: an opportunity for mindfulness-driven tourism in a post-pandemic world. Tour Geogr. 2020;22:703–12.

Article   Google Scholar  

Reina CS, Kudesia RS. Wherever you go, there you become: How mindfulness arises in everyday situations. Organ Behav Hum Decis Process. 2020;159:78–96.

Conversano C, Di Giuseppe M, Miccoli M, Ciacchini R, Gemignani A, Orrù G. Mindfulness, age and gender as protective factors against psychological distress during COVID-19 pandemic. Front Psychol. 2020. https://doi.org/10.3389/fpsyg.2020.01900 .

Article   PubMed   PubMed Central   Google Scholar  

Shankland R, Tessier D, Strub L, Gauchet A, Baeyens C. Improving mental health and well-being through informal mindfulness practices: an intervention study. Appl Psychol Health Well Being. 2021;13:63–83.

Feldman O, Goldstien E, Rolnik B, Ganz AB, Lev-Ari S. Inquiry based stress reduction (IBSR) improves overall stuttering experience among adults who stutter: a randomized controlled trial. J Clin Med. 2021;10:2187.

Zadok-Gurman T, Jakobovich R, Dvash E, Zafrani K, Rolnik B, Ganz AB, et al. Effect of inquiry-based stress reduction (IBSR) intervention on well-being, resilience and burnout of teachers during the COVID-19 pandemic. Int J Environ Res Public Health. 2021;18:3689.

Long R, Halvorson M, Lengua LJ. A mindfulness-based promotive coping program improves well-being in college undergraduates. Anxiety, Stress, & Coping. 2021;0:1–14.

Layous K, Chancellor J, Lyubomirsky S, Wang L, Doraiswamy PM. Delivering happiness: translating positive psychology intervention research for treating major and minor depressive disorders. J Altern Complem Med. 2011;17:675–83.

Sin NL, Lyubomirsky S. Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: a practice-friendly meta-analysis. J Clin Psychol. 2009;65:467–87.

Fava GA, Rafanelli C, Cazzaro M, Conti S, Grandi S. Well-being therapy. A novel psychotherapeutic approach for residual symptoms of affective disorders. Psychol Med. 1998;28:475–80.

Fava GA, Ruini C, Rafanelli C, Finos L, Salmaso L, Mangelli L, et al. Well-being therapy of generalized anxiety disorder. Psychother Psychosom. 2005;74:26–30.

Steck EL, Abrams LM, Phelps L. Positive psychology in the prevention of eating disorders. Psychol Schs. 2004;41:111–7.

Huta V. Eudaimonia versus Hedonia: What Is the Difference? And Is It Real? | International Journal of Existential Positive Psychology. In: Special Issue: Proceedings of the 2016 Meaning Conference. International Journal of Existential Positive Psychology; 2018. p. 8. http://journal.existentialpsychology.org/index.php/ExPsy/article/view/230 . Accessed 20 Jul 2020.

Ryff CD, Dienberg Love G, Urry HL, Muller D, Rosenkranz MA, Friedman EM, et al. Psychological well-being and ill-being: do they have distinct or mirrored biological correlates? Psychother Psychosom. 2006;75:85–95.

Waterman AS, Schwartz SJ, Zamboanga BL, Ravert RD, Williams MK, Agocha VB, et al. The Questionnaire for Eudaimonic well-being: psychometric properties, demographic comparisons, and evidence of validity. J Posit Psychol. 2010;5:41–61.

Huta V. Eudaimonia in oxford handbook of happiness. Oxford, GB: Oxford University Press; 2013. https://doi.org/10.1093/oxfordhb/9780199557257.013.0015 .

Book   Google Scholar  

Garland EL, Farb NA, Goldin P, Fredrickson BL. Mindfulness Broadens awareness and builds eudaimonic meaning: a process model of mindful positive emotion regulation. Psychol Inq. 2015;26:293–314.

Waterman AS. On the importance of distinguishing hedonia and eudaimonia when contemplating the hedonic treadmill. Am Psychol. 2007;62:612–3.

Fredrickson BL. The broaden–and–build theory of positive emotions. Phil Trans R Soc Lond B. 2004;359:1367–77.

Chang J-H, Huang C-L, Lin Y-C. Mindfulness, basic psychological needs fulfillment, and well-being. J Happiness Stud. 2015;16:1149–62.

Wolsko C, Lindberg K. Experiencing connection with nature: The matrix of psychological well-being, mindfulness, and outdoor recreation. Ecopsychology. 2013;5:80–91.

Hong PY, Lishner DA, Han KH. Mindfulness and eating: an experiment examining the effect of mindful raisin eating on the enjoyment of sampled food. Mindfulness. 2014;5:80–7.

Malboeuf-Hurtubise C, Taylor G, Lefrançois D, Essopos I, Lacourse E. The impact of a mindfulness-based intervention on happiness: a reflection on the relevance of integrating a positive psychology framework within mindfulness research in youth. Int J Appl Posit Psychol. 2018;2:23–37.

Howells A, Ivtzan I, Eiroa-Orosa FJ. Putting the ‘app’ in happiness: a randomised controlled trial of a smartphone-based mindfulness intervention to enhance wellbeing. J Happiness Stud. 2016;17:163–85.

Nyklícek I, Kuijpers KF. Effects of mindfulness-based stress reduction intervention on psychological well-being and quality of life: is increased mindfulness indeed the mechanism? Ann Behav Med. 2008;35:331–40.

Munoz RT, Hoppes S, Hellman CM, Brunk KL, Bragg JE, Cummins C. The effects of mindfulness meditation on hope and stress. Res Soc Work Pract. 2018;28:696–707.

Heckenberg RA, Hale MW, Kent S, Wright BJ. An online mindfulness-based program is effective in improving affect, over-commitment, optimism and mucosal immunity. Physiol Behav. 2019;199:20–7.

Schonert-Reichl KA, Lawlor MS. The effects of a mindfulness-based education program on pre- and early adolescents’ well-being and social and emotional competence. Mindfulness. 2010;1:137–51.

Flook L, Goldberg SB, Pinger L, Davidson RJ. Promoting prosocial behavior and self-regulatory skills in preschool children through a mindfulness-based Kindness Curriculum. Dev Psychol. 2015;51:44–51.

Scott-Hamilton J, Schutte NS, Brown RF. Effects of a mindfulness intervention on sports-anxiety, pessimism, and flow in competitive cyclists. Appl Psychol Health Well Being. 2016;8:85–103.

Quach D, Jastrowski Mano KE, Alexander K. A randomized controlled trial examining the effect of mindfulness meditation on working memory capacity in adolescents. J Adolesc Health. 2016;58:489–96.

Franco C, Mañas I, Cangas AJ, Gallego J. The Applications of Mindfulness with Students of Secondary School: Results on the Academic Performance, Self-concept and Anxiety. In: Lytras MD, Ordonez De Pablos P, Ziderman A, Roulstone A, Maurer H, Imber JB, editors. Knowledge Management, Information Systems, E-Learning, and Sustainability Research. Berlin, Heidelberg: Springer; 2010. p. 83–97.

Risk of bias tools - Current version of RoB 2. https://sites.google.com/site/riskofbiastool/welcome/rob-2-0-tool/current-version-of-rob-2 . Accessed 16 Dec 2020.

Amutio A, Martínez-Taboada C, Hermosilla D, Delgado LC. Enhancing relaxation states and positive emotions in physicians through a mindfulness training program: a one-year study. Psychol Health Med. 2015;20:720–31.

de Vibe M, Solhaug I, Rosenvinge JH, Tyssen R, Hanley A, Garland E. Six-year positive effects of a mindfulness-based intervention on mindfulness, coping and well-being in medical and psychology students; Results from a randomized controlled trial. PLoS ONE. 2018;13:e0196053.

Räsänen P, Lappalainen P, Muotka J, Tolvanen A, Lappalainen R. An online guided ACT intervention for enhancing the psychological wellbeing of university students: a randomized controlled clinical trial. Behav Res Ther. 2016;78:30–42.

Devcich DA, Rix G, Bernay R, Graham E. Effectiveness of a mindfulness-based program on school children’s self-reported well-being: a pilot study comparing effects with an emotional literacy program. J Appl Sch Psychol. 2017;33:309–30.

Huppert FA, Johnson DM. A controlled trial of mindfulness training in schools: the importance of practice for an impact on well-being. J Posit Psychol . 2010;5:264–74.

Forrest CB, Bevans KB, Filus A, Devine J, Becker BD, Carle AC, et al. Assessing children’s eudaimonic well-being: the PROMIS pediatric meaning and purpose item banks. J Pediatr Psychol. 2019;44:1074–82.

MacMullin K, Jerry P, Cook K. Psychotherapist experiences with telepsychotherapy: pre COVID-19 lessons for a post COVID-19 world. J Psychother Integr. 2020;30:248. https://doi.org/10.1037/int0000213 .

Poletti B, Tagini S, Brugnera A, Parolin L, Pievani L, Ferrucci R, et al. Telepsychotherapy: a leaflet for psychotherapists in the age of COVID-19. A review of the evidence. Counselling Psychology Quarterly. 2020;0:1–16.

Huberty J, Green J, Glissmann C, Larkey L, Puzia M, Lee C. Efficacy of the mindfulness meditation mobile app “calm” to reduce stress among College students: randomized controlled trial. JMIR Mhealth Uhealth. 2019;7:e14273.

Bhayee S, Tomaszewski P, Lee DH, Moffat G, Pino L, Moreno S, et al. Attentional and affective consequences of technology supported mindfulness training: a randomised, active control, efficacy trial. BMC Psychol. 2016;4:60.

Champion L, Economides M, Chandler C. The efficacy of a brief app-based mindfulness intervention on psychosocial outcomes in healthy adults: A pilot randomised controlled trial. PLoS ONE. 2018;13:e0209482.

Carson JW, Carson KM, Gil KM, Baucom DH. Mindfulness-based relationship enhancement. Behav Ther. 2004;35:471–94.

Coatsworth JD, Duncan LG, Nix RL, Greenberg MT, Gayles JG, Bamberger KT, et al. Integrating mindfulness with parent training: effects of the mindfulness-enhanced strengthening families program. Dev Psychol. 2015;51:26–35.

Kappen G, Karremans JC, Burk WJ. Effects of a short online mindfulness intervention on relationship satisfaction and partner acceptance: the moderating role of trait mindfulness. Mindfulness. 2019;10:2186–99.

Neff KD, Germer CK. A pilot study and randomized controlled trial of the mindful self-compassion program. J Clin Psychol. 2013;69:28–44.

Yela JR, Gómez-Martínez MÁ, Crego A, Jiménez L. Effects of the Mindful Self-Compassion programme on clinical and health psychology trainees’ well-being: a pilot study. Clin Psychol. 2020;24:41–54.

Fredrickson BL, Cohn MA, Coffey KA, Pek J, Finkel SM. Open hearts build lives: positive emotions, induced through loving-kindness meditation, build consequential personal resources. J Pers Soc Psychol. 2008;95:1045–62.

Sorensen S, Steindl SR, Dingle GA, Garcia A. Comparing the effects of loving-kindness meditation (LKM), music and LKM plus music on psychological well-being. J Psychol. 2019;153:267–87.

Rodríguez-Carvajal R, García-Rubio C, Paniagua D, García-Diex G, De Rivas S. Mindfulness integrative model (MIM): Cultivating positive states of mind towards oneself and the others through mindfulness and self-compassion. Anales de Psicologia. 2016;32:749–60.

Pogrebtsova E, Craig J, Chris A, O’Shea D, González-Morales MG. Exploring daily affective changes in university students with a mindful positive reappraisal intervention: a daily diary randomized controlled trial. Stress Health. 2018;34:46–58.

Vich M, Lukeš M, Burian J. Out of sight, out of mind? Exploring the long-term effects of Relational Mindfulness Training (RMT). J Contextual Behav Sci. 2020;16:162–71.

Ivtzan I, Young T, Martman J, Jeffrey A, Lomas T, Hart R, et al. Integrating mindfulness into positive psychology: a randomised controlled trial of an online positive mindfulness program. Mindfulness. 2016;7:1396–407.

Smith BM, Ong CW, Barrett TS, Bluett EJ, Slocum TA, Twohig MP. Longitudinal effects of a 2-year meditation and buddhism program on well-being, quality of life, and valued living. Mindfulness. 2019;10:2095–109.

Deci EL, Ryan RM. Hedonia, eudaimonia, and well-being: an introduction. J Happiness Stud. 2008;9:1–11.

Aknin LB, Norton MI, Dunn EW. From wealth to well-being? Money matters, but less than people think: The Journal of Positive Psychology: Vol 4, No 6. J Posit Psychol. 2009;4:523–7.

Howell RT, Hill G. The mediators of experiential purchases: Determining the impact of psychological needs satisfaction and social comparison. J Posit Psychol. 2009;4:511–22.

Kashdan TB, Breen WE. Materialism and diminished well–being: experiential avoidance as a mediating mechanism. J Soc Clin Psychol. 2007;26:521–39.

Keyes CLM, Annas J. Feeling good and functioning well: distinctive concepts in ancient philosophy and contemporary science. J Posit Psychol. 2009;4:197–201.

Moher D, Liberati A, Tetzlaff J, Altman DG, Group TP. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLOS Med. 2009;6:e1000097.

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Allen, J.G., Romate, J. & Rajkumar, E. Mindfulness-based positive psychology interventions: a systematic review. BMC Psychol 9 , 116 (2021). https://doi.org/10.1186/s40359-021-00618-2

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Positive affect and reward processing in the treatment of depression, anxiety and trauma

• Michelle G. Craske   ORCID: orcid.org/0000-0002-3704-5240 1 , 2 ,
• Barnaby D. Dunn 3 ,
• Alicia E. Meuret 4 ,
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The inability to experience pleasure or interest in activities (commonly referred to in clinical settings as anhedonia) is characteristic of depression, anxiety, post-traumatic stress disorder and other mental health conditions. Diminished positive emotions and anhedonia predict poor long-term outcomes, but conventional psychological treatments have only modest effects upon positive emotions. In this Review, we consider the impact of diminished positive affect and anhedonia on depression, anxiety and trauma and present evidence to suggest underlying deficits in reward processing. We describe psychological treatments that aim to increase positive emotions — including emerging therapies and neurocognitive training programmes that specifically target reward hyposensitivities — and the supporting evidence for their efficacy. We argue that a paradigm shift away from treatments primarily focused on alleviating negative emotions (the current gold standard) towards treatments that augment reward processing and positive emotions will prove valuable to enhance treatment response and overall quality of life of people with mental health conditions.

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Westerhof, G. J. & Keyes, C. L. Mental illness and mental health: the two continua model across the lifespan. J. Adult Dev. 17 , 110–119 (2010).

Article   PubMed   Google Scholar  

Keyes, C. L. The mental health continuum: from languishing to flourishing in life. J. Health Soc. Behav. 43 , 207–222 (2002).

Watson, D. in Handbook of Positive Psychology 106–119 (Oxford Univ. Press, 2002).

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 5th edn, text revision (DSM-5-TR) (2022).

World Health Organization. International Statistical Classification of Diseases and Related Health Problems (ICD) https://www.who.int/standards/classifications/classification-of-diseases (2019).

Dunn, B. D. in The Oxford Handbook of Positive Emotion and Psychopathology (ed. Gruber, J.) 539–560 (Oxford Univ. Press, 2019).

Taylor, C. T., Hoffman, S. N. & Khan, A. J. Anhedonia in anxiety disorders. Curr. Top. Behav. Neurosci. 58 , 201–218 (2022). This article thoroughly reviews anhedonia in anxiety disorders.

Krzyzanowski, D. J. et al. Trait anhedonia in schizophrenia: a systematic review and comparative meta-analysis. Schizophr. Bull. 48 , 335–346 (2022).

Garfield, J. B. B., Lubman, D. I. & Yücel, M. Anhedonia in substance use disorders: a systematic review of its nature, course and clinical correlates. Aust. N. Z. J. Psychiatry 48 , 36–51 (2013).

Garland, E. L., Trostheim, M., Eikemo, M., Ernst, G. & Leknes, S. Anhedonia in chronic pain and prescription opioid misuse. Psychol. Med. 50 , 1977–1988 (2020).

Dolan, S. C. et al. Anhedonia in eating disorders: a meta-analysis and systematic review. Int. J. Eat. Disord. 55 , 161–175 (2022).

Vinograd, M., Stout, D. M. & Risbrough, V. B. Anhedonia in posttraumatic stress disorder: prevalence, phenotypes, and neural circuitry. Curr. Top. Behav. Neurosci. 58 , 185–199 (2022). This article thoroughly reviews anhedonia in post-traumatic stress disorder.

Hatzigiakoumis, D. S., Martinotti, G., Giannantonio, M. D. & Janiri, L. Anhedonia and substance dependence: clinical correlates and treatment options. Front. Psychiatry 2 , 10 (2011).

Article   PubMed   PubMed Central   Google Scholar  

Lambert, C. et al. Anhedonia in depression and schizophrenia: a transdiagnostic challenge. CNS Neurosci. Ther. 24 , 615–623 (2018).

Scott, B. M. et al. From pleasure to pounding: distinct patterns of anhedonia and impulsivity linked to motivational disturbances in Parkinson disease. Appl. Neuropsychol. Adult https://doi.org/10.1080/23279095.2022.2146506 (2022).

Guineau, M. G. et al. Anhedonia as a transdiagnostic symptom across psychological disorders: a network approach. Psychol. Med. 53 , 3908–3919 (2023).

Barkus, E. & Badcock, J. C. A transdiagnostic perspective on social anhedonia. Front. Psychiatry 10 , 216 (2019).

Alsayednasser, B. et al. How well do cognitive behavioural therapy and behavioural activation for depression repair anhedonia? A secondary analysis of the COBRA randomized controlled trial. Behav. Res. Ther. 159 , 104185 (2022).

Pelizza, L. & Ferrari, A. Anhedonia in schizophrenia and major depression: state or trait? Ann. Gen. Psychiatry 8 , 22 (2009).

Carragher, N. et al. Discriminant validity and gender differences in DSM-5 posttraumatic stress disorder symptoms. J. Affect. Disord. 190 , 56–67 (2016).

Carmassi, C. et al. Frequency of trauma exposure and post-traumatic stress disorder in Italy: analysis from the World Mental Health Survey Initiative. J. Psychiatr. Res. 59 , 77–84 (2014).

Franklin, C. L. & Zimmerman, M. Posttraumatic stress disorder and major depressive disorder: investigating the role of overlapping symptoms in diagnostic comorbidity. J. Nerv. Ment. Dis. 189 , 548–551 (2001).

Duek, O., Seidemann, R., Pietrzak, R. H. & Harpaz-Rotem, I. Distinguishing emotional numbing symptoms of posttraumatic stress disorder from major depressive disorder. J. Affect. Disord. 324 , 294–299 (2023).

Prenoveau, J. M. et al. Testing a hierarchical model of anxiety and depression in adolescents: a tri-level model. J. Anxiety Disord. 24 , 334–344 (2010).

Naragon-Gainey, K., Prenoveau, J. M., Brown, T. A. & Zinbarg, R. E. A comparison and integration of structural models of depression and anxiety in a clinical sample: support for and validation of the tri-level model. J. Abnorm. Psychol. 125 , 853–867 (2016).

Khazanov, G. K. & Ruscio, A. M. Is low positive emotionality a specific risk factor for depression? A meta-analysis of longitudinal studies. Psychol. Bull. 142 , 991–1015 (2016).

Sandman, C. F. & Craske, M. G. Psychological treatments for anhedonia. Curr. Top. Behav. Neurosci. 58 , 491–513 (2022).

Hoffman, S. N., Rassaby, M. M., Stein, M. B. & Taylor, C. T. Positive and negative affect change following psychotherapeutic treatment for anxiety-related disorders: a systematic review and meta-analysis. J. Affect. Disord. 349 , 358–369 (2024).

Dunn, B. D. et al. Changes in positive and negative affect during pharmacological treatment and cognitive therapy for major depressive disorder: a secondary analysis of two randomized controlled trials. Clin. Psychol. Sci. 8 , 36–51 (2019). This secondary analysis of two randomized controlled trials shows that cognitive behavioural therapy, antidepressive medication combined treatment do not fully repair positive affect in depression.

Article   Google Scholar  

McCabe, C., Mishor, Z., Cowen, P. J. & Harmer, C. J. Diminished neural processing of aversive and rewarding stimuli during selective serotonin reuptake inhibitor treatment. Biol. Psychiatry 67 , 439–445 (2010).

Macoveanu, J. Serotonergic modulation of reward and punishment: evidence from pharmacological fMRI studies. Brain Res. 1556 , 19–27 (2014).

Cao, B. et al. Pharmacological interventions targeting anhedonia in patients with major depressive disorder: a systematic review. Prog. Neuropsychopharmacol. Biol. Psychiatry 92 , 109–117 (2019). This is a comprehensive review on the impact of pharmacotherapy agents on anhedonia in depression.

Serretti, A. Anhedonia and depressive disorders. Clin. Psychopharmacol. Neurosci. 21 , 401–409 (2023).

Wang, S., Leri, F. & Rizvi, S. J. Anhedonia as a central factor in depression: neural mechanisms revealed from preclinical to clinical evidence. Prog. Neuropsychopharmacol. Biol. Psychiatry 110 , 110289 (2021).

Vinograd, M. & Craske, M. G. Using neuroscience to augment behavioral interventions for depression. Harv. Rev. Psychiatry 28 , 14–25 (2020).

Fredrickson, B. L. The role of positive emotions in positive psychology. The broaden-and-build theory of positive emotions. Am. Psychol. 56 , 218–226 (2001).

Fusar-Poli, P. et al. The lived experience of depression: a bottom-up review co-written by experts by experience and academics. World Psychiatry 22 , 352–365 (2023). This review provides a phenomenology viewpoint emphasizing that absence of positive emotion experiences is core to the lived experience of depression.

Cummergen, K. et al. What outcomes matter to service users who experience persistent depression: a mixed-method narrative review and synthesis. J. Affect. Disord. Rep. 10 , 100431 (2022).

Demyttenaere, K. et al. What is important in being cured from depression? Discordance between physicians and patients (1). J. Affect. Disord. 174 , 390–396 (2015).

Kendall, A. D. et al. Prospective associations of low positive emotionality with first onsets of depressive and anxiety disorders: results from a 10-wave latent trait-state modeling study. J. Abnorm. Psychol. 124 , 933–943 (2015).

Rackoff, G. N. & Newman, M. G. Reduced positive affect on days with stress exposure predicts depression, anxiety disorders, and low trait positive affect 7 years later. J. Abnorm. Psychol. 129 , 799–809 (2020).

Sequeira, S. L., Forbes, E. E., Hanson, J. L. & Silk, J. S. Positive valence systems in youth anxiety development: a scoping review. J. Anxiety Disord. 89 , 102588 (2022). This comprehensive empirical review proposes a theoretical model of positive valence processing in child and adolescent anxiety.

Acheson, D. T. et al. Prospective examination of pre-trauma anhedonia as a risk factor for post-traumatic stress symptoms. Eur. J. Psychotraumatol. 13 , 2015949 (2022).

Haim-Nachum, S. et al. Anhedonia mediates the relationships between childhood trauma and symptom severity of PTSD and depression, but not of social anxiety. J. Affect. Disord. 344 , 577–584 (2024).

Yarrington, J. S. et al. The role of positive and negative aspects of life events in depressive and anxiety symptoms. Clin. Psychol. Sci. 11 , 910–920 (2023).

Spijker, J., Bijl, R. V., de Graaf, R. & Nolen, W. A. Determinants of poor 1-year outcome of DSM-III-R major depression in the general population: results of the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Acta Psychiatr. Scand. 103 , 122–130 (2001).

Vinckier, F., Gourion, D. & Mouchabac, S. Anhedonia predicts poor psychosocial functioning: results from a large cohort of patients treated for major depressive disorder by general practitioners. Eur. Psychiatry 44 , 1–8 (2017).

Dunn, B. et al. Does mindfulness-based cognitive therapy with tapering support reduce risk of relapse/recurrence in major depressive disorder by enhancing positive affect? A secondary analysis of the PREVENT trial. J. Consult. Clin. Psychol. (in the press).

Breslau, N., Reboussin, B. A., Anthony, J. C. & Storr, C. L. The structure of posttraumatic stress disorder: latent class analysis in 2 community samples. Arch. Gen. Psychiatry 62 , 1343–1351 (2005).

North, C. S., Suris, A. M., Davis, M. & Smith, R. P. Toward validation of the diagnosis of posttraumatic stress disorder. Am. J. Psychiatry 166 , 34–41 (2009).

Hassija, C. M., Jakupcak, M. & Gray, M. J. Numbing and dysphoria symptoms of posttraumatic stress disorder among Iraq and Afghanistan war veterans: a review of findings and implications for treatment. Behav. Modif. 36 , 834–856 (2012).

Guerra, V. S. & Calhoun, P. S. Examining the relation between posttraumatic stress disorder and suicidal ideation in an OEF/OIF veteran sample. J. Anxiety Disord. 25 , 12–18 (2011).

Taylor, S. et al. Posttraumatic stress disorder arising after road traffic collisions: patterns of response to cognitive-behavior therapy. J. Consult. Clin. Psychol. 69 , 541–551 (2001).

May, C. L., Wisco, B. E., Fox, V. A., Marx, B. P. & Keane, T. M. Posttraumatic stress disorder-related anhedonia as a predictor of psychosocial functional impairment among United States veterans. J. Trauma. Stress 35 , 1334–1342 (2022).

Ducasse, D. et al. Anhedonia is associated with suicidal ideation independently of depression: a meta-analysis. Depress. Anxiety 35 , 382–392 (2018). This meta-analysis reviews evidence linking anhedonia to suicidal ideation.

Gillissie, E. S. et al. Evaluating anhedonia as a risk factor in suicidality: a meta-analysis. J. Psychiatr. Res. 158 , 209–215 (2023).

Ducasse, D. et al. Association between anhedonia and suicidal events in patients with mood disorders: a 3-year prospective study. Depress. Anxiety 38 , 17–27 (2021).

DeRubeis, R. J. et al. Cognitive therapy vs medications in the treatment of moderate to severe depression. Arch. Gen. Psychiatry 62 , 409–416 (2005).

Widnall, E., Price, A., Trompetter, H. & Dunn, B. D. Routine cognitive behavioural therapy for anxiety and depression is more effective at repairing symptoms of psychopathology than enhancing wellbeing. Cognit. Ther. Res. 44 , 28–39 (2019).

Uher, R. et al. Depression symptom dimensions as predictors of antidepressant treatment outcome: replicable evidence for interest–activity symptoms. Psychol. Med. 42 , 967–980 (2012).

McMakin, D. L. et al. Anhedonia predicts poorer recovery among youth with selective serotonin reuptake inhibitor treatment-resistant depression. J. Am. Acad. Child Adolesc. Psychiatry 51 , 404–411 (2012).

Khazanov, G. K. et al. Distress and anhedonia as predictors of depression treatment outcome: a secondary analysis of a randomized clinical trial. Behav. Res. Ther. 125 , 103507 (2020).

Downar, J. et al. Anhedonia and reward-circuit connectivity distinguish nonresponders from responders to dorsomedial prefrontal repetitive transcranial magnetic stimulation in major depression. Biol. Psychiatry 76 , 176–185 (2014).

Taylor, C. T. et al. What good are positive emotions for treatment? A replication test of whether trait positive emotionality predicts response to exposure therapy for social anxiety disorder. Behav. Res. Ther. 171 , 104436 (2023).

Norris, L. A., Rabner, J. C., Mennies, R. J., Olino, T. M. & Kendall, P. C. Increased self-reported reward responsiveness predicts better response to cognitive behavioral therapy for youth with anxiety. J. Anxiety Disord. 80 , 102402 (2021).

Sewart, A. R. et al. Examining positive and negative affect as outcomes and moderators of cognitive-behavioral therapy and acceptance and commitment therapy for social anxiety disorder. Behav. Ther. 50 , 1112–1124 (2019).

Watson, D., Clark, L. A. & Tellegen, A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J. Pers. Soc. Psychol. 54 , 1063 (1988).

Gard, D. E., Gard, M. G., Kring, A. M. & John, O. P. Anticipatory and consummatory components of the experience of pleasure: a scale development study. J. Res. Pers. 40 , 1086–1102 (2006).

Snaith, R. P. et al. A scale for the assessment of hedonic tone the Snaith–Hamilton Pleasure Scale. Br. J. Psychiatry 167 , 99–103 (1995).

Rizvi, S. J. et al. Development and validation of the Dimensional Anhedonia Rating Scale (DARS) in a community sample and individuals with major depression. Psychiatry Res. 229 , 109–119 (2015).

Khazanov, G. K., Ruscio, A. M. & Forbes, C. N. The Positive Valence Systems Scale: development and validation. Assessment 27 , 1045–1069 (2020).

Rømer Thomsen, K., Whybrow, P. C. & Kringelbach, M. L. Reconceptualizing anhedonia: novel perspectives on balancing the pleasure networks in the human brain. Front. Behav. Neurosci. 9 , 49 (2015).

PubMed   PubMed Central   Google Scholar  

Alexander, R. et al. The neuroscience of positive emotions and affect: implications for cultivating happiness and wellbeing. Neurosci. Biobehav. Rev. 121 , 220–249 (2021).

Der-Avakian, A. & Markou, A. The neurobiology of anhedonia and other reward-related deficits. Trends Neurosci. 35 , 68–77 (2012).

Haber, S. N. & Knutson, B. The reward circuit: linking primate anatomy and human imaging. Neuropsychopharmacology 35 , 4–26 (2010).

Husain, M. & Roiser, J. P. Neuroscience of apathy and anhedonia: a transdiagnostic approach. Nat. Rev. Neurosci. 19 , 470–484 (2018).

Halahakoon, D. C. et al. Reward-processing behavior in depressed participants relative to healthy volunteers: a systematic review and meta-analysis. JAMA Psychiatry 77 , 1286–1295 (2020). This meta-analysis discusses the strength of the evidence linking reward processing components with depression.

Rupprechter, S., Stankevicius, A., Huys, Q. J. M., Steele, J. D. & Seriès, P. Major depression impairs the use of reward values for decision-making. Sci. Rep. 8 , 13798 (2018).

Treadway, M. T. & Zald, D. H. Reconsidering anhedonia in depression: lessons from translational neuroscience. Neurosci. Biobehav. Rev. 35 , 537–555 (2011).

Rupprechter, S., Stankevicius, A., Huys, Q. J. M., Series, P. & Steele, J. D. Abnormal reward valuation and event-related connectivity in unmedicated major depressive disorder. Psychol. Med. 51 , 795–803 (2021).

Treadway, M. T. & Salamone, J. D. Vigor, effort-related aspects of motivation and anhedonia. Curr. Top. Behav. Neurosci. 58 , 325–353 (2022).

Park, I. H., Lee, B. C., Kim, J. J., Kim, J. I. & Koo, M. S. Effort-based reinforcement processing and functional connectivity underlying amotivation in medicated patients with depression and schizophrenia. J. Neurosci. 37 , 4370–4380 (2017).

Klawohn, J., Joyner, K., Santopetro, N., Brush, C. J. & Hajcak, G. Depression reduces neural correlates of reward salience with increasing effort over the course of the progressive ratio task. J. Affect. Disord. 307 , 294–300 (2022).

Amlung, M. et al. Delay discounting as a transdiagnostic process in psychiatric disorders: a meta-analysis. JAMA Psychiatry 76 , 1176–1186 (2019).

Renner, F. et al. Prospective mental imagery in depression: impact on reward processing and reward-motivated behaviour. Clin. Psychol. Eur. 3 , e3013 (2021).

May, C. L. & Wisco, B. E. Reward processing and decision-making in posttraumatic stress disorder. Behav. Ther. 51 , 814–828 (2020).

Engelmann, J. B., Meyer, F., Fehr, E. & Ruff, C. C. Anticipatory anxiety disrupts neural valuation during risky choice. J. Neurosci. 35 , 3085–3099 (2015).

Pittig, A., Boschet, J. M., Glück, V. M. & Schneider, K. Elevated costly avoidance in anxiety disorders: patients show little downregulation of acquired avoidance in face of competing rewards for approach. Depress. Anxiety 38 , 361–371 (2021).

Weaver, S. S. et al. Sacrificing reward to avoid threat: characterizing PTSD in the context of a trauma-related approach–avoidance conflict task. J. Abnorm. Psychol. 129 , 457–468 (2020).

Borsini, A., Wallis, A. S. J., Zunszain, P., Pariante, C. M. & Kempton, M. J. Characterizing anhedonia: a systematic review of neuroimaging across the subtypes of reward processing deficits in depression. Cogn. Affect. Behav. Neurosci. 20 , 816–841 (2020).

Whitton, A. E., Treadway, M. T. & Pizzagalli, D. A. Reward processing dysfunction in major depression, bipolar disorder and schizophrenia. Curr. Opin. Psychiatry 28 , 7–12 (2015).

Keren, H. et al. Reward processing in depression: a conceptual and meta-analytic review across fMRI and EEG studies. Am. J. Psychiatry 175 , 1111–1120 (2018).

Yang, X. et al. Neurofunctional mapping of reward anticipation and outcome for major depressive disorder: a voxel-based meta-analysis. Psychol. Med. 52 , 3309–3322 (2022).

Phillips, R. D. et al. Striatal dopamine in anhedonia: a simultaneous [ 11 C]raclopride positron emission tomography and functional magnetic resonance imaging investigation. Psychiatry Res. Neuroimaging 333 , 111660 (2023).

Auerbach, R. P. et al. Reward-related neural circuitry in depressed and anxious adolescents: a Human Connectome Project. J. Am. Acad. Child Adolesc. Psychiatry 61 , 308–320 (2022).

Olino, T. M. et al. Reduced reward anticipation in youth at high-risk for unipolar depression: a preliminary study. Dev. Cogn. Neurosci. 8 , 55–64 (2014).

Morgan, J. K. et al. Maternal response to positive affect moderates the impact of familial risk for depression on ventral striatal response to winning reward in 6- to 8-year-old children. Biol. Psychiatry Cogn. Neurosci. Neuroimaging 7 , 824–832 (2022).

Luking, K. R., Nelson, B. D., Infantolino, Z. P., Sauder, C. L. & Hajcak, G. Ventral striatal function interacts with positive and negative life events to predict concurrent youth depressive symptoms. Biol. Psychiatry Cogn. Neurosci. Neuroimaging 3 , 937–946 (2018).

PubMed   Google Scholar  

Morgan, J. K., Olino, T. M., McMakin, D. L., Ryan, N. D. & Forbes, E. E. Neural response to reward as a predictor of increases in depressive symptoms in adolescence. Neurobiol. Dis. 52 , 66–74 (2013).

Nelson, B. D., Perlman, G., Klein, D. N., Kotov, R. & Hajcak, G. Blunted neural response to rewards as a prospective predictor of the development of depression in adolescent girls. Am. J. Psychiatry 173 , 1223–1230 (2016).

Stringaris, A. et al. The brain’s response to reward anticipation and depression in adolescence: dimensionality, specificity, and longitudinal predictions in a community-based sample. Am. J. Psychiatry 172 , 1215–1223 (2015).

Burani, K. et al. Neural response to rewards, stress and sleep interact to prospectively predict depressive symptoms in adolescent girls. J. Clin. Child Adolesc. Psychol. 50 , 131–140 (2021).

Burani, K. et al. Cumulative lifetime acute stressor exposure interacts with reward responsiveness to predict longitudinal increases in depression severity in adolescence. Psychol. Med. 53 , 4507–4516 (2023).

Luking, K. R., Pagliaccio, D., Luby, J. L. & Barch, D. M. Reward processing and risk for depression across development. Trends Cogn. Sci. 20 , 456–468 (2016).

Pizzagalli, D. A. Toward a better understanding of the mechanisms and pathophysiology of anhedonia: are we ready for translation? Am. J. Psychiatry 179 , 458–469 (2022).

Yang, X. et al. Neurofunctional mapping of reward anticipation and outcome for major depressive disorder: a voxel-based meta-analysis. Psychol. Med . https://doi.org/10.1017/s0033291722002707 (2022).

Forbes, E. E. et al. Altered striatal activation predicting real-world positive affect in adolescent major depressive disorder. Am. J. Psychiatry 166 , 64–73 (2009).

Fonzo, G. A. Diminished positive affect and traumatic stress: a biobehavioral review and commentary on trauma affective neuroscience. Neurobiol. Stress 9 , 214–230 (2018).

Lokshina, Y., Nickelsen, T. & Liberzon, I. Reward processing and circuit dysregulation in posttraumatic stress disorder. Front. Psychiatry 12 , 559401 (2021).

Nawijn, L. et al. Reward functioning in PTSD: a systematic review exploring the mechanisms underlying anhedonia. Neurosci. Biobehav. Rev. 51 , 189–204 (2015).

Seidemann, R., Duek, O., Jia, R., Levy, I. & Harpaz-Rotem, I. The reward system and post-traumatic stress disorder: does trauma affect the way we interact with positive stimuli. Chronic Stress 5 , 2470547021996006 (2021).

Bennett, M. M., Davis, K. E. & Fitzgerald, J. M. Neural correlates of reward processing in the onset, maintenance, and treatment of posttraumatic stress disorder. Biol. Psychiatry Cogn. Neurosci. Neuroimaging 8 , 884–890 (2023).

Richey, J. A. et al. Spatiotemporal dissociation of brain activity underlying threat and reward in social anxiety disorder. Soc. Cogn. Affect. Neurosci. 12 , 81–94 (2017).

Richey, J. A. et al. Sensitivity shift theory: a developmental model of positive affect and motivational deficits in social anxiety disorder. Clin. Psychol. Rev. 72 , 101756 (2019).

Sambuco, N., Bradley, M. M. & Lang, P. J. Trauma-related dysfunction in the fronto-striatal reward circuit. J. Affect. Disord. 287 , 359–366 (2021).

Ben-Zion, Z. et al. Evaluating the evidence for brain-based biotypes of psychiatric vulnerability in the acute aftermath of trauma. Am. J. Psychiatry 180 , 146–154 (2023).

Guyer, A. E. et al. Striatal functional alteration during incentive anticipation in pediatric anxiety disorders. Am. J. Psychiatry 169 , 205–212 (2012).

Lahat, A., Benson, B. E., Pine, D. S., Fox, N. A. & Ernst, M. Neural responses to reward in childhood: relations to early behavioral inhibition and social anxiety. Soc. Cogn. Affect. Neurosci. 13 , 281–289 (2018).

Bashford-Largo, J. et al. Reduced neural differentiation of rewards and punishment during passive avoidance learning in adolescents with generalized anxiety disorder. Depress. Anxiety 38 , 794–803 (2021).

Khazanov, G. K., Ruscio, A. M. & Swendsen, J. The ‘brightening’ effect: reactions to positive events in the daily lives of individuals with major depressive disorder and generalized anxiety disorder. Behav. Ther. 50 , 270–284 (2019).

Pugach, C. P., May, C. L. & Wisco, B. E. Positive emotion in posttraumatic stress disorder: a global or context-specific problem? J. Trauma. Stress 36 , 444–456 (2023).

Heininga, V. E. et al. The dynamical signature of anhedonia in major depressive disorder: positive emotion dynamics, reactivity, and recovery. BMC Psychiatry 19 , 59 (2019).

Mukherjee, D., Lee, S. A. & Almeida, D. Daily affective dynamics in major depressive disorder: the role of daily stressors and positive events. Affect. Sci. 4 , 757–769 (2023).

van Loo, H. M., Booij, S. H. & Jeronimus, B. F. Testing the mood brightening hypothesis: hedonic benefits of physical, outdoor, and social activities in people with anxiety, depression or both. J. Affect. Disord. 325 , 215–223 (2023).

Morgan, J. K. et al. Altered positive affect in clinically anxious youth: the role of social context and anxiety subtype. J. Abnorm. Child Psychol. 45 , 1461–1472 (2017).

Whitton, A. E. & Pizzagalli, D. A. Anhedonia in depression and bipolar disorder. Curr. Top. Behav. Neurosci. 58 , 111–127 (2022).

Rothkirch, M., Tonn, J., Kohler, S. & Sterzer, P. Neural mechanisms of reinforcement learning in unmedicated patients with major depressive disorder. Brain 140 , 1147–1157 (2017).

Eckstrand, K. L. et al. Anhedonia reduction and the association between left ventral striatal reward response and 6-month improvement in life satisfaction among young adults. JAMA Psychiatry 76 , 958–965 (2019).

Morris, B. H. & Rottenberg, J. Heightened reward learning under stress in generalized anxiety disorder: a predictor of depression resistance? J. Abnorm. Psychol. 124 , 115–127 (2015).

Reilly, E. E. et al. Diagnostic and dimensional evaluation of implicit reward learning in social anxiety disorder and major depression. Depress. Anxiety 37 , 1221–1230 (2020).

Brown, V. M. et al. Reinforcement learning disruptions in individuals with depression and sensitivity to symptom change following cognitive behavioral therapy. JAMA Psychiatry 78 , 1113–1122 (2021).

Hiser, J. et al. Decision-making for concurrent reward and threat is differentially modulated by trauma exposure and PTSD symptom severity. Behav. Res. Ther. 167 , 104361 (2023).

Rutherford, A. V., McDougle, S. D. & Joormann, J. ‘Don’t [ruminate], be happy’: a cognitive perspective linking depression and anhedonia. Clin. Psychol. Rev. 101 , 102255 (2023).

Gallagher, M. R., Collins, A. C. & Winer, E. S. A network analytic investigation of avoidance, dampening, and devaluation of positivity. J. Behav. Ther. Exp. Psychiatry 81 , 101870 (2023).

Winer, E. S., Jordan, D. G. & Collins, A. C. Conceptualizing anhedonias and implications for depression treatments. Psychol. Res. Behav. Manag. 12 , 325–335 (2019).

Winer, E. S. & Salem, T. Reward devaluation: dot-probe meta-analytic evidence of avoidance of positive information in depressed persons. Psychol. Bull. 142 , 18 (2016). This article explains avoidance of positivity in depression through a reward devaluation theory framework.

Grafton, B. & MacLeod, C. A positive perspective on attentional bias: positive affectivity and attentional bias to positive information. J. Happiness Stud. 18 , 1029–1043 (2016).

Noguchi, K., Gohm, C. L. & Dalsky, D. J. Cognitive tendencies of focusing on positive and negative information. J. Res. Pers. 40 , 891–910 (2006).

Xu, Y. et al. Positive affect promotes well-being and alleviates depression: the mediating effect of attentional bias. Psychiatry Res. 228 , 482–487 (2015).

Vanderlind, W. M., Millgram, Y., Baskin-Sommers, A. R., Clark, M. S. & Joormann, J. Understanding positive emotion deficits in depression: from emotion preferences to emotion regulation. Clin. Psychol. Rev. 76 , 101826 (2020).

Alden, L. E., Taylor, C. T., Mellings, T. M. & Laposa, J. M. Social anxiety and the interpretation of positive social events. J. Anxiety Disord. 22 , 577–590 (2008).

Weeks, J. W. & Howell, A. N. The bivalent fear of evaluation model of social anxiety: further integrating findings on fears of positive and negative evaluation. Cogn. Behav. Ther. 41 , 83–95 (2012).

Cook, S. I., Moore, S., Bryant, C. & Phillips, L. J. The role of fear of positive evaluation in social anxiety: a systematic review and meta-analysis. Clin. Psychol. Sci. Pract. 29 , 352–369 (2022).

Mennin, D. S., Heimberg, R. G., Turk, C. L. & Fresco, D. M. Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder. Behav. Res. Ther. 43 , 1281–1310 (2005).

Eisner, L. R., Johnson, S. L. & Carver, C. S. Positive affect regulation in anxiety disorders. J. Anxiety Disord. 23 , 645–649 (2009).

Wolkenstein, L., Sommerhoff, A. & Voss, M. Positive emotion dysregulation in posttraumatic stress disorder. J. Anxiety Disord. 86 , 102534 (2022).

Bean, C. A. L., Summers, C. B. & Ciesla, J. A. Dampening of positive affect and depression: a meta-analysis of cross-sectional and longitudinal relationships. Behav. Res. Ther. 156 , 104153 (2022).

Boelen, P. A. Dampening of positive affect is associated with posttraumatic stress following stressful life events. Eur. J. Psychotraumatol. 12 , 1851077 (2021).

Abasi, I. et al. Positive emotion regulation strategies as mediators in depression and generalized anxiety disorder symptoms: a transdiagnostic framework investigation. Curr. Psychol. 42 , 800–807 (2021).

Malivoire, B. L., Marcotte-Beaumier, G., Sumantry, D. & Koerner, N. Correlates of dampening and savoring in generalized anxiety disorder. Int. J. Cogn. Ther. 15 , 414–433 (2022).

Everaert, J., Bronstein, M. V., Castro, A. A., Cannon, T. D. & Joormann, J. When negative interpretations persist, positive emotions don’t! Inflexible negative interpretations encourage depression and social anxiety by dampening positive emotions. Behav. Res. Ther. 124 , 103510 (2020).

Werner-Seidler, A., Banks, R., Dunn, B. D. & Moulds, M. L. An investigation of the relationship between positive affect regulation and depression. Behav. Res. Ther. 51 , 46–56 (2013).

Bogaert, L. et al. The effect of universal school-based mindfulness on anhedonia and emotional distress and its underlying mechanisms: a cluster randomised controlled trial via experience sampling in secondary schools. Behav. Res. Ther. 169 , 104405 (2023).

Nelis, S., Bastin, M., Raes, F. & Bijttebier, P. When do good things lift you up? Dampening, enhancing, and uplifts in relation to depressive and anhedonic symptoms in early adolescence. J. Youth Adolesc. 47 , 1712–1730 (2018).

Yilmaz, M., Psychogiou, L., Ford, T. & Dunn, B. D. Examining the relationship between anhedonia symptoms and trait positive appraisal style in adolescents: a longitudinal survey study. J. Adolesc. 91 , 71–81 (2021).

Dunn, B. D. et al. Turning gold into lead: dampening appraisals reduce happiness and pleasantness and increase sadness during anticipation and recall of pleasant activities in the laboratory. Behav. Res. Ther. 107 , 19–33 (2018).

Yilmaz, M., Psychogiou, L., Javaid, M., Ford, T. & Dunn, B. D. Making the worst of a good job: induced dampening appraisals blunt happiness and increase sadness in adolescents during pleasant memory recall. Behav. Res. Ther. 122 , 103476 (2019).

Burr, L. A., Javiad, M., Jell, G., Werner-Seidler, A. & Dunn, B. D. Turning lemonade into lemons: dampening appraisals reduce positive affect and increase negative affect during positive activity scheduling. Behav. Res. Ther. 91 , 91–101 (2017).

Weiss-Cowie, S., Verhaeghen, P. & Duarte, A. An updated account of overgeneral autobiographical memory in depression. Neurosci. Biobehav. Rev. 149 , 105157 (2023).

Hallford, D. J., Rusanov, D., Yeow, J. J. E. & Barry, T. J. Reduced specificity and increased overgenerality of autobiographical memory persist as cognitive vulnerabilities in remitted major depression: a meta-analysis. Clin. Psychol. Psychother. 29 , 1515–1529 (2022).

Ono, M., Devilly, G. J. & Shum, D. H. A meta-analytic review of overgeneral memory: the role of trauma history, mood, and the presence of posttraumatic stress disorder. Psychol. Trauma 8 , 157–164 (2016).

Askelund, A. D., Schweizer, S., Goodyer, I. M. & van Harmelen, A.-L. Positive memory specificity is associated with reduced vulnerability to depression. Nat. Hum. Behav. 3 , 265–273 (2019).

Hallford, D. J., Rusanov, D., Yeow, J. J. E. & Barry, T. J. Overgeneral and specific autobiographical memory predict the course of depression: an updated meta-analysis. Psychol. Med. 51 , 909–926 (2021).

Holmes, E. A., Blackwell, S. E., Burnett Heyes, S., Renner, F. & Raes, F. Mental imagery in depression: phenomenology, potential mechanisms, and treatment implications. Annu. Rev. Clin. Psychol. 12 , 249–280 (2016).

Du, J. Y., Hallford, D. J. & Busby Grant, J. Characteristics of episodic future thinking in anxiety: a systematic review and meta-analysis. Clin. Psychol. Rev. 95 , 102162 (2022).

Hallford, D. J., Austin, D. W., Takano, K. & Raes, F. Psychopathology and episodic future thinking: a systematic review and meta-analysis of specificity and episodic detail. Behav. Res. Ther. 102 , 42–51 (2018).

Kleim, B., Graham, B., Fihosy, S., Stott, R. & Ehlers, A. Reduced specificity in episodic future thinking in posttraumatic stress disorder. Clin. Psychol. Sci. 2 , 165–173 (2014).

Hallford, D. J. et al. Impairments in episodic future thinking for positive events and anticipatory pleasure in major depression. J. Affect. Disord. 260 , 536–543 (2020).

Thompson, R. et al. Positive and negative affective forecasting in remitted individuals with bipolar I disorder, and major depressive disorder, and healthy controls. Cogn. Ther. Res . https://doi.org/10.1007/s10608-017-9840-2 (2017).

Hallford, D. J. et al. Reducing anhedonia in major depressive disorder with Future Event Specificity Training (FEST): a randomized controlled trial. Cognit. Ther. Res. 47 , 20–37 (2023).

Anderson, Z. et al. Association between reward-related functional connectivity and tri-level mood and anxiety symptoms. NeuroImage Clin. 37 , 103335 (2023).

Liverant, G. I., Arditte Hall, K. A., Wieman, S. T., Pineles, S. L. & Pizzagalli, D. A. Associations between insomnia and reward learning in clinical depression. Psychol. Med . 52 , 3540–3549 (2021).

Pittig, A., Wong, A. H. K., Gluck, V. M. & Boschet, J. M. Avoidance and its bi-directional relationship with conditioned fear: mechanisms, moderators, and clinical implications. Behav. Res. Ther. 126 , 103550 (2020).

Kujawa, A. & Burkhouse, K. L. Vulnerability to depression in youth: advances from affective neuroscience. Biol. Psychiatry Cogn. Neurosci. Neuroimaging 2 , 28–37 (2017).

Nielson, D. M. et al. Great expectations: a critical review of and suggestions for the study of reward processing as a cause and predictor of depression. Biol. Psychiatry 89 , 134–143 (2021). This review critically examines the causal link between reward processing alterations and depression.

Mackin, D. M. et al. Longitudinal associations between reward responsiveness and depression across adolescence. J. Am. Acad. Child Adolesc. Psychiatry 62 , 816–828 (2023).

Lewinsohn, P. M. in The Psychology of Depression: Contemporary Theory and Research (eds Freedman, R. J. & Katz, M.) 157–174 (Wiley, 1974).

Reiss, S. & Bootzin, R. R. Theoretical Issues in Behavior Therapy (Academic Press, 1985).

Martell, C. R., Dimidjian, S. & Herman-Dunn, R. in Behavioral Activation for Depression : A Clinician’s Guide (Guilford Press, 2010).

Dimidjian, S., Barrera, M. Jr, Martell, C., Muñoz, R. F. & Lewinsohn, P. M. The origins and current status of behavioral activation treatments for depression. Annu. Rev. Clin. Psychol. 7 , 1–38 (2011).

Cuijpers, P., van Straten, A. & Warmerdam, L. Behavioral activation treatments of depression: a meta-analysis. Clin. Psychol. Rev. 27 , 318–326 (2007).

Dichter, G. S. et al. The effects of psychotherapy on neural responses to rewards in major depression. Biol. Psychiatry 66 , 886–897 (2009).

Moore, R. C. et al. A randomized clinical trial of behavioral activation (BA) therapy for improving psychological and physical health in dementia caregivers: results of the Pleasant Events Program (PEP). Behav. Res. Ther. 51 , 623–632 (2013).

Mazzucchelli, T., Kane, R. & Rees, C. Behavioral activation interventions for well-being: a meta-analysis. J. Posit. Psychol. 5 , 105–121 (2010).

Dunn, B. D. Helping depressed clients reconnect to positive emotion experience: current insights and future directions. Clin. Psychol. Psychother. 19 , 326–340 (2012).

Forbes, C. N. New directions in behavioral activation: using findings from basic science and translational neuroscience to inform the exploration of potential mechanisms of change. Clin. Psychol. Rev. 79 , 101860 (2020).

Duckworth, A. L., Steen, T. A. & Seligman, M. E. P. Positive psychology in clinical practice. Annu. Rev. Clin. Psychol. 1 , 629–651 (2005).

Koslouski, J. et al. Measuring emotional well-being through subjective report: a scoping review of reviews. BMJ Open 12 , e062120 (2022).

Linton, M. J., Dieppe, P. & Medina-Lara, A. Review of 99 self-report measures for assessing well-being in adults: exploring dimensions of well-being and developments over time. BMJ Open 6 , e010641 (2016).

Sin, N. L. & Lyubomirsky, S. Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: a practice-friendly meta-analysis. J. Clin. Psychol. 65 , 467–487 (2009).

Seligman, M. E., Steen, T. A., Park, N. & Peterson, C. Positive psychology progress: empirical validation of interventions. Am. Psychol. 60 , 410–421 (2005).

van Agteren, J. et al. A systematic review and meta-analysis of psychological interventions to improve mental wellbeing. Nat. Hum. Behav. 5 , 631–652 (2021).

Chaves, C., Lopez-Gomez, I., Hervas, G. & Vazquez, C. A comparative study on the efficacy of a positive psychology intervention and a cognitive behavioral therapy for clinical depression. Cogn. Ther. Res. 41 , 417–433 (2017).

Bannink, F. P. Positive CBT: From reducing distress to building success. J. Contemp. Psychother. 44 , 1–8 (2014).

Geschwind, N., Arntz, A., Bannink, F. & Peeters, F. Positive cognitive behavior therapy in the treatment of depression: a randomized order within-subject comparison with traditional cognitive behavior therapy. Behav. Res. Ther. 116 , 119–130 (2019).

Dunn, B. D. et al. Bringing light into darkness: a multiple baseline mixed methods case series evaluation of augmented depression therapy (ADepT). Behav. Res. Ther . 120 , 103418 (2019).

Dunn, B. D. et al. Preliminary clinical and cost effectiveness of augmented depression therapy versus cognitive behavioural therapy for the treatment of anhedonic depression (ADepT): a single-centre, open-label, parallel-group, pilot, randomised, controlled trial. eClinicalMedicine 61 , 102084 (2023). This is a preliminary trial on the efficacy of augmented depression therapy against conventional psychotherapy.

Craske, M. G. et al. Positive affect treatment for depression and anxiety: a randomized clinical trial for a core feature of anhedonia. J. Consult. Clin. Psychol. 87 , 457 (2019).

Craske, M. G., Meuret, A. E., Echiverri-Cohen, A., Rosenfield, D. & Ritz, T. Positive affect treatment targets reward sensitivity: a randomized controlled trial. J. Consult. Clin. Psychol. 91 , 350–366 (2023). This is an experimental therapeutics-based replication trial on the efficacy and target engagement of positive affect treatment against negative affect treatment.

Barnes-Horowitz, N. M. et al. Changes in positive and negative affect in psychotherapy for depression and anxiety. J. Consult. Clin. Psychol. 92 , 249–259 (2023).

Bryant, R. et al. Positive affect training to reduce mental health problems during the COVID-19 pandemic: a proof-of-concept randomised clinical trial. BMJ Ment. Health 26 , e300767 (2023).

LaFreniere, L. S. & Newman, M. G. Upregulating positive emotion in generalized anxiety disorder: a randomized controlled trial of the SkillJoy ecological momentary intervention. J. Consult. Clin. Psychol. 91 , 381 (2023).

LaFreniere, L. S. & Newman, M. G. Savoring changes novel positive mindset targets of GAD treatment: optimism, prioritizing positivity, kill-joy thinking, and worry mediation. Behav. Res. Ther. 177 , 104541 (2024).

Kumar, D., Corner, S., Kim, R. & Meuret, A. A randomized controlled trial of brief behavioral activation plus savoring for positive affect dysregulation in university students. Behav. Res. Ther. 177 , 104525 (2024).

Taylor, C. T., Lyubomirsky, S. & Stein, M. B. Upregulating the positive affect system in anxiety and depression: outcomes of a positive activity intervention. Depress. Anxiety 34 , 267–280 (2017).

Taylor, C. T., Pearlstein, S. L., Kakaria, S., Lyubomirsky, S. & Stein, M. B. Enhancing social connectedness in anxiety and depression through amplification of positivity: preliminary treatment outcomes and process of change. Cognit. Ther. Res. 44 , 788–800 (2020).

Kryza-Lacombe, M. et al. Changes in neural reward processing following amplification of positivity treatment for depression and anxiety: preliminary findings from a randomized waitlist controlled trial. Behav. Res. Ther. 142 , 103860 (2021).

Taylor, C. T. et al. Amplification of positivity treatment for anxiety and depression: a randomized experimental therapeutics trial targeting social reward sensitivity to enhance social connectedness. Biol. Psychiatry 95 , 434–443 (2023). This is an experimental therapeutics-based replication trial on the efficacy and target engagement of amplification of positivity treatment against its short version.

Cernasov, P. et al. Multilevel growth curve analyses of behavioral activation for anhedonia (BATA) and mindfulness-based cognitive therapy effects on anhedonia and resting-state functional connectivity: interim results of a randomized trial ☆ . J. Affect. Disord. 292 , 161–171 (2021). This is a preliminary trial on the efficacy and neural mechanisms of behavioural activation for anhedonia against mindfulness-based cognitive therapy.

Dalgleish, T. & Werner-Seidler, A. Disruptions in autobiographical memory processing in depression and the emergence of memory therapeutics. Trends Cogn. Sci. 18 , 596–604 (2014). This article reviews core domains of autobiographical memory and its alterations.

MacLeod, A. Prospection, Well-Being, and Mental Health 255–274 (Oxford Univ. Press, 2017).

Raes, F., Williams, J. M. & Hermans, D. Reducing cognitive vulnerability to depression: a preliminary investigation of MEmory Specificity Training (MEST) in inpatients with depressive symptomatology. J. Behav. Ther. Exp. Psychiatry 40 , 24–38 (2009).

Werner-Seidler, A. et al. A cluster randomized controlled platform trial comparing group memory specificity training (MEST) to group psychoeducation and supportive counselling (PSC) in the treatment of recurrent depression. Behav. Res. Ther. 105 , 1–9 (2018).

Moradi, A. R. et al. A pilot randomized controlled trial investigating the efficacy of memory specificity training in improving symptoms of posttraumatic stress disorder. Behav. Res. Ther. 56 , 68–74 (2014).

Arditte Hall, K. A., De Raedt, R., Timpano, K. R. & Joormann, J. Positive memory enhancement training for individuals with major depressive disorder. Cogn. Behav. Ther. 47 , 155–168 (2018).

Blackwell, S. E. et al. Positive imagery-based cognitive bias modification as a web-based treatment tool for depressed adults: a randomized controlled trial. Clin. Psychol. Sci. 3 , 91–111 (2015).

Pictet, A., Jermann, F. & Ceschi, G. When less could be more: investigating the effects of a brief internet-based imagery cognitive bias modification intervention in depression. Behav. Res. Ther. 84 , 45–51 (2016).

Hallford, D. J. et al. Changing the future: an initial test of future specificity training (FeST). Behav. Res. Ther. 131 , 103638 (2020).

Bogaert, L., Hallford, D., Loyen, E., D’Argembeau, A. & Raes, F. Recalling and anticipating positive events to improve the positive affect and mental health of adolescents: a cluster randomized controlled trial in secondary schools. Behav. Res. Ther. 179 , 104543 (2024).

Bomyea, J. et al. Neural changes in reward processing following approach avoidance training for depression. Soc. Cogn. Affect. Neurosci. 17 , 336–349 (2021).

Bomyea, J. et al. Randomized controlled trial of computerized approach/avoidance training in social anxiety disorder: neural and symptom outcomes. J. Affect. Disord. 324 , 36–45 (2023).

Marzbani, H., Marateb, H. R. & Mansourian, M. Neurofeedback: a comprehensive review on system design, methodology and clinical applications. Basic Clin. Neurosci. 7 , 143–158 (2016). This review addresses the strengths and weaknesses of common protocols and their clinical applications.

Zotev, V., Mayeli, A., Misaki, M. & Bodurka, J. Emotion self-regulation training in major depressive disorder using simultaneous real-time fMRI and EEG neurofeedback. NeuroImage Clin. 27 , 102331 (2020).

Young, K. D. et al. Randomized clinical trial of real-time fMRI amygdala neurofeedback for major depressive disorder: effects on symptoms and autobiographical memory recall. Am. J. Psychiatry 174 , 748–755 (2017).

Young, K. D. et al. Real-time functional magnetic resonance imaging amygdala neurofeedback changes positive information processing in major depressive disorder. Biol. Psychiatry 82 , 578–586 (2017). This study shows that amygdala real-time functional MRI neurofeedback can increase brain response to positively valenced memories and heighten amygdala activity to happy faces.

Young, K. D. et al. Altered task-based and resting-state amygdala functional connectivity following real-time fMRI amygdala neurofeedback training in major depressive disorder. NeuroImage Clin. 17 , 691–703 (2018).

Compère, L. et al. Amygdala real-time fMRI neurofeedback upregulation in treatment resistant depression: proof of concept and dose determination. Behav. Res. Ther. 176 , 104523 (2024). This preliminary study investigates the use of neurofeedback for treating resistant depression.

Hellrung, L. et al. Analysis of individual differences in neurofeedback training illuminates successful self-regulation of the dopaminergic midbrain. Commun. Biol. 5 , 845 (2022).

Li, K. et al. Functional near-infrared spectroscopy-informed neurofeedback: regional-specific modulation of lateral orbitofrontal activation and cognitive flexibility. Neurophotonics 6 , 025011 (2019).

Freedland, K. E. et al. The selection of comparators for randomized controlled trials of health-related behavioral interventions: recommendations of an NIH expert panel. J. Clin. Epidemiol. 110 , 74–81 (2019).

Michalska, K. J. & Davis, E. L. The psychobiology of emotional development: the case for examining sociocultural processes. Dev. Psychobiol. 61 , 416–429 (2019).

Volynets, S., Glerean, E., Hietanen, J. K., Hari, R. & Nummenmaa, L. Bodily maps of emotions are culturally universal. Emotion 20 , 1127–1136 (2020).

Immordino-Yang, M. H., Yang, X. F. & Damasio, H. Cultural modes of expressing emotions influence how emotions are experienced. Emotion 16 , 1033–1039 (2016).

Peng, Y. et al. Failure to identify robust latent variables of positive or negative valence processing across units of analysis. Biol. Psychiatry Cogn. Neurosci. Neuroimaging 6 , 518–526 (2021).

Insel, T. R. The NIMH experimental medicine initiative. World Psychiatry 14 , 151–153 (2015).

Krystal, A. D. et al. A randomized proof-of-mechanism trial applying the ‘fast-fail’ approach to evaluating κ-opioid antagonism as a treatment for anhedonia. Nat. Med. 26 , 760–768 (2020).

Elliott, M. L. et al. What is the test–retest reliability of common task-functional MRI measures? New empirical evidence and a meta-analysis. Psychol. Sci. 31 , 792–806 (2020).

Dang, J., King, K. M. & Inzlicht, M. Why are self-report and behavioral measures weakly correlated? Trends Cogn. Sci. 24 , 267–269 (2020).

Hall, A. F., Browning, M. & Huys, Q. J. M. The computational structure of consummatory anhedonia. Trends Cognit. Sci. 28 , 541–553 (2024).

Norbury, A., Hauser, T. U., Fleming, S. M., Dolan, R. J. & Huys, Q. J. M. Different components of cognitive-behavioral therapy affect specific cognitive mechanisms. Sci. Adv. 10 , eadk3222 (2024).

Bassett, D. S., Zurn, P. & Gold, J. I. On the nature and use of models in network neuroscience. Nat. Rev. Neurosci. 19 , 566–578 (2018).

Mancuso, L. et al. Tasks activating the default mode network map multiple functional systems. Brain Struct. Funct. 227 , 566–578 (2022).

Rao, L.-L., Zhou, Y., Zheng, D., Yang, L.-Q. & Li, S. Genetic contribution to variation in risk taking: a functional MRI twin study of the balloon analogue risk task. Psychol. Sci. 29 , 1679–1691 (2018).

Stanton, C. H., Holmes, A. J., Chang, S. W. C. & Joormann, J. From stress to anhedonia: molecular processes through functional circuits. Trends Neurosci. 42 , 23–42 (2019).

Nord, C. L. et al. A transdiagnostic meta-analysis of acute augmentations to psychological therapy. Nat. Ment. Health 1 , 389–401 (2023).

Watkins, E., Newbold, A., Tester-Jones, M., Collins, L. M. & Mostazir, M. Investigation of active ingredients within internet-delivered cognitive behavioral therapy for depression: a randomized optimization trial. JAMA Psychiatry 80 , 942–951 (2023).

Robert, G., Donetto, S. & Williams, O. in The Palgrave Handbook of Co-Production of Public Services and Outcomes 313 (Palgrave, 2020).

Burkhouse, K. L. et al. Targeting positive valence systems function in children of mothers with depressive symptoms: a pilot randomized trial of an RDoC-informed preventive intervention. Behav. Res. Ther. 168 , 104384 (2023).

Ford, B. Q. & Mauss, I. B. Culture and emotion regulation. Curr. Opin. Psychol. 3 , 1–5 (2015).

Krys, K. et al. Societal emotional environments and cross-cultural differences in life satisfaction: a forty-nine country study. J. Posit. Psychol. 17 , 117–130 (2022).

Li, L. Y., Cicero, D. C., Dodell-Feder, D., Germine, L. & Martin, E. A. Comparability of social anhedonia across epidemiological dimensions: a multinational study of measurement invariance of the revised social anhedonia scale. Psychol. Assess. 33 , 171–179 (2021).

Janssen, N. P. et al. How does behavioural activation work? A systematic review of the evidence on potential mediators. Psychother. Psychosom. 90 , 85–93 (2021).

Goodwin, G. M., Price, J., De Bodinat, C. & Laredo, J. Emotional blunting with antidepressant treatments: a survey among depressed patients. J. Affect. Disord. 221 , 31–35 (2017).

McIntyre, R. S., Loft, H. & Christensen, M. C. Efficacy of vortioxetine on anhedonia: results from a pooled analysis of short-term studies in patients with major depressive disorder. Neuropsychiatr. Dis. Treat. 17 , 575–585 (2021).

Shukuroglou, M. et al. Changes in music-evoked emotion and ventral striatal functional connectivity after psilocybin therapy for depression. J. Psychopharmacol. 37 , 70–79 (2023).

Katzman, M. A. et al. Efficacy of adjunctive brexpiprazole on symptom clusters of major depressive disorder: a post hoc analysis of four clinical studies. J. Affect. Disord. 316 , 201–208 (2022).

Yatham, L. N. et al. Broad efficacy of cariprazine on depressive symptoms in bipolar disorder and the clinical implications. Prim. Care Companion CNS Disord. https://doi.org/10.4088/PCC.20m02611 (2020).

Vaccarino, S. et al. Functional neuroimaging biomarkers of anhedonia response to escitalopram plus adjunct aripiprazole treatment for major depressive disorder. Br. J. Psych. Open 10 , e18 (2024).

Batinic, B., Ristic, I., Zugic, M. & Baldwin, D. S. Treatment of symptom clusters in schizophrenia, bipolar disorder and major depressive disorder with the dopamine D3/D2 preferring partial agonist cariprazine. Front. Psychiatry 12 , 784370 (2021).

Ventorp, F. et al. Preliminary evidence of efficacy and target engagement of pramipexole in anhedonic depression. Psychiatr. Res. Clin. Pract. 4 , 42–47 (2022).

Phillips, R. D. et al. Striatal dopamine in anhedonia: a simultaneous [ 11 C] raclopride positron emission tomography and functional magnetic resonance imaging investigation. Psychiatry Res. Neuroimaging 333 , 111660 (2023).

McIntyre, R. S., Gommoll, C., Chen, C. & Ruth, A. The efficacy of levomilnacipran ER across symptoms of major depressive disorder: a post hoc analysis of 5 randomized, double-blind, placebo-controlled trials. CNS Spectr. 21 , 385–392 (2016).

Rizvi, S. J., Geraci, J., Ravindran, A. & Kennedy, S. H. Predictors of response to adjunctive osmotic-release methylphenidate or placebo in patients with major depressive disorder: effects of apathy/anhedonia and fatigue. J. Clin. Psychopharmacol. 34 , 755–759 (2014).

Barbano, M. F. & Cador, M. Opioids for hedonic experience and dopamine to get ready for it. Psychopharmacology 191 , 497–506 (2007).

Schneider, M., Heise, V. & Spanagel, R. Differential involvement of the opioid receptor antagonist naloxone in motivational and hedonic aspects of reward. Behav. Brain Res. 208 , 466–472 (2010).

Browne, C. A. & Lucki, I. Targeting opioid dysregulation in depression for the development of novel therapeutics. Pharmacol. Ther. 201 , 51–76 (2019).

Pizzagalli, D. A. et al. Selective kappa-opioid antagonism ameliorates anhedonic behavior: evidence from the Fast-fail Trial in Mood and Anxiety Spectrum Disorders (FAST-MAS). Neuropsychopharmacology 45 , 1656–1663 (2020).

Nogo, D. et al. The effect of ketamine on anhedonia: improvements in dimensions of anticipatory, consummatory, and motivation-related reward deficits. Psychopharmacology 239 , 2011–2039 (2022).

Kotoula, V. et al. Ketamine modulates the neural correlates of reward processing in unmedicated patients in remission from depression. Biol. Psychiatry Cogn. Neurosci. Neuroimaging 7 , 285–292 (2022).

Riggs, L. M. & Gould, T. D. Ketamine and the future of rapid-acting antidepressants. Annu. Rev. Clin. Psychol. 17 , 207–231 (2021).

Cardona-Acosta, A. M. & Bolaños-Guzmán, C. A. Role of the mesolimbic dopamine pathway in the antidepressant effects of ketamine. Neuropharmacology 225 , 109374 (2023).

Molero, P. et al. Antidepressant efficacy and tolerability of ketamine and esketamine: a critical review. CNS Drugs 32 , 411–420 (2018).

Derosa, S. et al. Changes in neurotrophic signaling pathways in brain areas of the chronic mild stress rat model of depression as a signature of ketamine fast antidepressant response/non-response. Prog. Neuropsychopharmacol. Biol. Psychiatry 128 , 110871 (2024).

Jacobson, L. H., Vlachou, S., Slattery, D. A., Li, X. & Cryan, J. F. The gamma-aminobutyric acid B receptor in depression and reward. Biol. Psychiatry 83 , 963–976 (2018).

Lim, B. et al. Understanding the effects of chronic benzodiazepine use in depression: a focus on neuropharmacology. Int. Clin. Psychopharmacol. 35 , 243–253 (2020).

Meshkat, S. et al. Clinical efficacy and safety of zuranolone (SAGE-217) in individuals with major depressive disorder. J. Affect. Disord. 340 , 893–898 (2023).

Lucatch, A. M., Kloiber, S. M., Meyer, J. H., Rizvi, S. J. & George, T. P. Effects of extended cannabis abstinence in major depressive disorder. Can. J. Addict. 11 , 33–41 (2020).

Reuveni, N. et al. The antidepressant and anxiolytic effects of cannabinoids in chronic unpredictable stress: a preclinical systematic review and meta-analysis. Transl. Psychiatry 12 , 217 (2022).

Jacobs, W., Merianos, A. L., Quinn, P., Barrington-Trimis, J. & Leventhal, A. Association of self-reported use of cannabis for the purpose of improving physical, mental, and sleep health with problematic cannabis use risk. BMC Public Health 23 , 1560 (2023).

van Laar, M. W. et al. Cannabis and COVID-19: reasons for concern. Front. Psychiatry 11 , 601653 (2020).

Villanueva, C. M., Silton, R. L., Heller, W., Barch, D. M. & Gruber, J. Change is on the horizon: call to action for the study of positive emotion and reward in psychopathology. Curr. Opin. Behav. Sci. 39 , 34–40 (2021).

Berridge, K. C. & Robinson, T. E. Parsing reward. Trends Neurosci. 26 , 507–513 (2003).

Rizvi, S. J., Pizzagalli, D. A., Sproule, B. A. & Kennedy, S. H. Assessing anhedonia in depression: potentials and pitfalls. Neurosci. Biobehav. Rev. 65 , 21–35 (2016). This comprehensive review critically analyses measures assessing anhedonia and components of reward processing.

Blevins, E. et al. Cultural variation in neural responses to social but not monetary reward outcomes. Soc. Cogn. Affect. Neurosci. 18 , nsad068 (2023).

Senft, N., Campos, B., Shiota, M. N. & Chentsova-Dutton, Y. E. Who emphasizes positivity? An exploration of emotion values in people of Latino, Asian, and European heritage living in the United States. Emotion 21 , 707–719 (2021).

Spreckelmeyer, K. N. et al. Anticipation of monetary and social reward differently activates mesolimbic brain structures in men and women. Soc. Cogn. Affect. Neurosci. 4 , 158–165 (2009).

Rademacher, L., Salama, A., Grunder, G. & Spreckelmeyer, K. N. Differential patterns of nucleus accumbens activation during anticipation of monetary and social reward in young and older adults. Soc. Cogn. Affect. Neurosci. 9 , 825–831 (2014).

White, S. F., Nusslock, R. & Miller, G. E. Low socioeconomic status is associated with a greater neural response to both rewards and losses. J. Cogn. Neurosci. 34 , 1939–1951 (2022).

Craske, M. G., Herzallah, M. M., Nusslock, R. & Patel, V. From neural circuits to communities: an integrative multidisciplinary roadmap for global mental health. Nat. Ment. Health 1 , 12–24 (2023).

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Michelle G. Craske

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Sakina J. Rizvi

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M.G.C. and A.E.M. are the developers of Positive Affect Treatment (PAT) and receive payments from Oxford University Press for the related workbooks. M.G.C. also receives payments for book royalties from American Psychological Association and from Elsevier (as Editor-in-Chief of Behaviour Research and Therapy) and payment for editorial work for UpToDate, Inc. B.D.D. is the developer of Augmented Depression Therapy (ADepT) and receives payments for ad hoc workshops on ADepT. C.T.T. is the developer of Amplification of Positivity (AMP) treatment and, in the past 3 years, has been a paid consultant for Bionomics and receives payment for editorial work for UpToDate, Inc. S.J.R. has received research funds or consulting fees from Allergan Canada, Pfizer Canada, Neurocrine Biosciences Inc. and Janssen Pharmaceuticals. She is the copyright holder for the Dimensional Anhedonia Rating Scale.

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Craske, M.G., Dunn, B.D., Meuret, A.E. et al. Positive affect and reward processing in the treatment of depression, anxiety and trauma. Nat Rev Psychol 3 , 665–685 (2024). https://doi.org/10.1038/s44159-024-00355-4

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SYSTEMATIC REVIEW article

Positive psychology: looking back and looking forward.

• Department of Psychology, Institute on Aging, University of Wisconsin-Madison, Madison, WI, United States

Envisioning the future of positive psychology (PP) requires looking at its past. To that end, I first review prior critiques of PP to underscore that certain early problems have persisted over time. I then selectively examine recent research to illustrate progress in certain areas as well as draw attention to recurrent problems. Key among them is promulgation of poorly constructed measures of well-being and reliance on homogeneous, privileged research samples. Another concern is the commercialization of PP, which points to the need for greater oversight and quality control in profit-seeking endeavors. Looking ahead, I advocate for future science tied to contemporary challenges, particularly ever-widening inequality and the pandemic. These constitute intersecting catastrophes that need scientific attention. Such problems bring into focus “neglected negatives” that may be fueling current difficulties, including greed, indifference, and stupidity. Anger, which defies easy characterization as positive or negative, also warrants greater scientific study. Going forward I advocate for greater study of domains that likely nurture good lives and just societies – namely, participation in the arts and encounters with nature, both currently under study. Overall, my entreaty to PP is to reckon with persistent problems from its past, while striving toward a future that is societally relevant and virtuous.

Introduction

I have studied psychological well-being for over 30 years ( Ryff, 1989 , 2014 , 2018 ), seeking to define its essential features as well as learn about factors that promote or undermine well-being and probe how it matters for health. I bring this past experience and expertise to thinking about positive psychology (PP), noting that I have never considered myself a positive psychologist, mostly because it has always seemed misguided to me to partition science by valence. Everything that interests me involves complex blends of good and bad things, what Rilke called the beauty and terror of life. With these ideas in mind, I reflect about the future of PP by first looking at its past to highlight what it has, or has not, contributed over the last two decades. My views represent personal observations from an outsider who, from the outset, was dubious about the point of launching the PP movement.

I begin with a look at early critiques, including my own, that distilled various concerns about the launching of PP. Some of those problems have endured, such as the failure to embrace the deeper history of psychology and related fields that have long addressed optimal human functioning. This distortion undermines the building of cumulative and coherent knowledge, while also contributes to insularity within PP. Additional past critiques, some from within PP, emphasized the need to put negative and positive experience together, as in dialectical approaches. I made similar points along the way. For this essay, I describe work outside the PP umbrella doing exactly that, drawing largely on the Midlife in the United States (MIDUS) national longitudinal study 1 , which I have led over the past two decades.

Returning to PP, on the topic of scientific progress I highlight select contributions over the past 20 years, but again underscore that most of these topics predated PP. On the downside, two notable problems are discussed: (1) poorly constructed measures of well-being and problematic findings, which contradict the claim that PP rests on solid science; and (2) widespread use of homogeneous research samples (white, well-educated, Western) in PP, thereby ignoring how race/ethnicity, socioeconomic status, and culture matter for positive human functioning. Linked to these problems is widespread pursuit of financial profit, purportedly grounded in rigorous scientific findings. Such commercialization, illustrated by products and shopping carts on websites, makes clear that PP has become a major business. Money-making, I observe, is a strange counterpoint to the recurring emphasis on character strengths and virtue. Financial gain raises additional issues of ethical oversight and quality control in what is being sold.

Going forward, PP and the human sciences in general need to address contemporary societal problems. I focus on ever-widening inequality, now compounded by the pandemic. What we know is that the suffering is not occurring equally, but is happening disproportionately among those who were already vulnerable. These difficulties bring into high relief topics that psychology has largely neglected. Among pernicious negatives of our era that may be fueling the problems we see are greed and indifference, especially among the privileged, as well as stupidity, which seems to cut across educational strata. Anger is another important contemporary emotion that defies easy characterization as positive or negative. These topics stand in marked contrast to what PP was meant to correct – namely, the preoccupation with psychopathology, weakness and damage ( Seligman and Csikszentmihalyi, 2000 ).

Looking ahead, I examine factors that may be key in nourishing good lives and just societies, such as active engagement with the arts, broadly defined. Widespread initiatives are moving in this direction, though few emphasize the critical role of the arts in understanding human suffering, which I bring into high relief. A key question is whether great literature, music, poetry, painting, and film can activate caring and compassion, particularly among the advantaged. Encounters with nature constitute another domain for nourishing good lives, while also strengthening commitments to take care for our planet. I note currently unfolding work along these lines.

Looking Back

Early critiques of positive psychology.

Most cite Seligman and Csikszentmihalyi (2000) as the definitive statement of what PP was about and why it was needed. The essay began with the authors describing what led each of them to believe that psychology as a discipline was preoccupied with “pathology, weakness, and damage” (p. 7). These assertions were remarkably at odds with extensive literatures on the positive in clinical, developmental, existential, and humanistic psychology – decades of prior work, much of which I drew on to formulate an integrative model of psychological well-being ( Ryff, 1989 ). Instead, most of the foundational exegesis was devoted to describing the 15 articles that followed. All represented longstanding programs of research on such topics as evolution, subjective well-being, optimism, self-determination, maturity, health, wisdom, creativity, and giftedness. These realms were themselves notably at odds with the assertion that psychology was preoccupied with the negative, a point strangely missed by the founders of PP.

Three years later Psychological Inquiry published a target article titled “Does the Positive Psychology Movement Have Legs?” ( Lazarus, 2003 ), followed by numerous commentaries. Ryff (2003) found fault with many aspects of the Lazarus critique (e.g., subjectivism, dimensional versus discrete models of emotion, and cross-sectional research), most of which I clarified were not problems specific to PP. On the topic of emotion, however, I argued for joint focus on negative and positive emotions because “…bad things happen to people, and the healthy response is to feel the sadness, pain, frustration, fear, disappointment, anger, or shame resulting from the adverse experience. However, good things also happen to people, and the healthy response is to feel joy, pride, love, affection, pleasure, or contentment from such experience positive experiences. Thus, the capacity for experiencing and expressing both realms of emotion is central to healthy functioning.” (p. 154).

The unsatisfactory Lazarus critique meant that the central strengths and limitations of PP had not been addressed. On the credit side of the ledger, I praised the special issue for bringing together in the same forum research programs that addressed positive, healthy, adaptive features of human functioning, but underscored that everything assembled came from longstanding programs of prior research. Nothing meant to exemplify this new movement was new : “This myopia about past and present is damaging not for the superficial reason of taking credit for advances already contributed by others but for more serious problems of increasing the likelihood of reinventing wheels, both conceptual and empirical, such that science fails to be incremental and cumulative” ( Ryff, 2003 , p. 155).

To illustrate historical precursors, I drew on Coan’s (1977) Hero, Artist, Sage, or Saint. It described centuries of scholarly efforts to depict the more noble attributes of humankind, such as the ancient Greeks’ emphasis on reason and rationality, St. Augustine’s emphasis on close contact with the divine, the Renaissance emphasis on creative self-expression, and the poets and philosophers of the Enlightenment. I also noted James (1902/1958) eloquent writings about healthy-mindedness juxtaposed with the sick soul, along with others who formulated individuation ( Jung, 1933 ; Von Franz, 1964 ), ego development ( Erikson, 1959 ), maturity ( Allport, 1961 ), self-actualization ( Maslow, 1968 ), the fully functioning person ( Rogers, 1961 ), and positive mental health ( Jahoda, 1958 ).

My own work on well-being ( Ryff, 1989 ) had drawn extensively on these sources, while Ryan and Deci’s (2001) review of hedonic and eudaimonic well-being distilled other philosophical precursors. I noted other contributions on positive topics, such as studies of ego development ( Loevinger, 1976 ), adult personality development ( Helson and Srivastava, 2001 ), generativity ( McAdams and St. Aubin, 1998 ), the human quest for meaning ( Wong and Fry, 1998 ), effective coping and self-regulation ( Carver and Scheier, 1998 ), and proliferating research on human resilience and post-traumatic growth ( Tedeschi et al., 1998 ; Luthar et al., 2000 ). My point: “Taken as a whole, this impressive array of current and past research on the upside of human condition leaves one wondering what all the fanfare has been about. Positive psychology is alive and well, and it most assuredly has legs, which stretch back into the distant history of the discipline. It is only from particular vantage points, such as clinical or abnormal psychology that the positive focus constitutes a novelty. For other subfields, especially life-span developmental and personality psychology, there has always been a concern for healthy, optimal human functioning. Perhaps the main message in the positive psychology initiative is thus how deeply entrenched and divided are the subfields within which psychologists work” ( Ryff, 2003 , p. 157). Unfortunately, this failure to consider relevant wider literatures has persisted through time. More than a decade later, the positive in PP was defined entirely from “Three Foundational Documents” ( Pawelski, 2016 ), which included Seligman (1999) and Seligman and Csikszentmihalyi (2000) , and an unpublished paper from a 2000 conference in Akumal, Mexico organized by Seligman. Effectively, all meanings of the positive in PP emanated from its founder, thus more deeply entrenching the historical myopia.

My 2003 essay concluded with a call for psychology to organize its house of strengths and to be circumspect about generating new assessments: “Those who would add to the many tools already available need to be clear that they are not contributing to clutter – that is, generating instruments that are redundant with extant measures.” (p. 157). The concern went unheeded, as I detail later.

Calls to Put Negative and Positive Realms Together

Wong (2011) advocated for a balanced and interactive model of the good life: “the development of character strengths and resilience may benefit from prior experience of having overcome negative conditions” (p. 70). The call to maximize positive affect and minimize negative affect could also create a “happy person as a well-defended fortress, invulnerable to the vicissitudes of life” ( King, 2001 , p. 53). New to the discourse, Wong called for a balance between individualist and collectivist orientations, thereby signaling the need to address cultural issues. Similarly, Lomas and Ivtzan (2016) called for second wave positive psychology to recognize the insufficiency of the admonition of first wave PP to go beyond a psychology preoccupied with disorder and dysfunction. Negative states could be conducive to flourishing, calling again for recognition of the dialectical nature of wellbeing. Five dichotomies were examined: optimism versus pessimism, self-esteem versus humility, freedom versus restriction, forgiveness versus anger, and happiness versus sadness. Within each, the value of both sides was described. These ideas aligned with other prior work, such as Carver and Scheier’s (2003) observation that doubt and disengagement play critical roles alongside commitment and confidence as well as Larsen et al. (2003) emphasis on co-activation of positive and negative emotions that allow individuals to make sense of stressors and gain mastery over them.

At the 6th European Conference on PP in Moscow, I spoke about “Contradiction at the Core of the Positive Psychology Movement: The Essential Role of the Negative in Adaptive Human Functioning” ( Ryff, 2012 ), beginning with a quote from Dostoyevsky’s Notes From the Underground: “And why are you so firmly and triumphantly certain that only what is normal and positive – in short, only well-being is good for man? Is reason mistaken about what is good? After all perhaps prosperity isn’t the only thing that pleases mankind. Perhaps he is just as attracted to suffering. Perhaps suffering is just as good to him as prosperity.” I then drew on Mill’s (1893/1989) Autobiography: “Those only are happy, I thought, who have their minds fixed on some object other than their own happiness, on the happiness of others, on the improvement of mankind, even on some art or pursuit, followed not as a means, but as itself an ideal end. Aiming thus as something else, they find happiness by the way.”

Arguing that psychology should not be partitioned by valence because all lives encompass both positives and negatives, I provided three examples of how they might come together. In the first, the positive is construed as an antidote to the negative, such as how positive emotions can help undo negative emotions ( Fredrickson, 1998 ), or how psychological well-being can help prevent relapse of depression or anxiety ( Fava et al., 1998 ; Ruini and Fava, 2009 ). In the second, the negative is seen as the route or path to the positive, as in trauma contributing to personal growth ( Tedeschi et al., 1998 ), or the expression of negative emotion fostering relational intimacy ( Reis, 2001 ), or the expression of negative emotion in childhood contributing, via skilled parenting, to emotional development ( Gottman, 2001 ). In the third, the positive and negative emotions are inextricably linked, such that embedded within every negative is a positive and within every positive is a negative. This dialectical perspective is more common in interdependent cultural contexts, with our findings ( Miyamoto and Ryff, 2011 ) showing that Japanese adults report experiencing both positive and negative affect, whereas United States adults report mostly positive affect. The dialectical emotional style was also linked with better health (fewer physical symptoms) in Japan compared to the United States.

Around the same time, McNulty and Fincham (2012) issued an important new challenge to PP: to consider that psychological traits and processes are not inherently positive or negative, but can be either depending on the context in which they occur. This insight was illustrated with interpersonal research (longitudinal studies of marital partners). Four putatively positive processes (forgiveness, optimism, benevolent attributions, and kindness) were shown to be beneficial, or harmful, depending on the context in which they occurred. For example, whether forgiveness was linked with self-respect differed by levels of agreeableness of one’s partner. Martial satisfaction over time also varied depending on whether attributions for spouses’ undesirable behaviors were more or less benevolent. This work, including numerous other examples, offered compelling evidence that simplistic characterizations of phenomena as positive or negative are misguided.

Integrative Work Outside the Positive Psychology Umbrella

Extensive research not part of PP has brought negative and positive aspects of human experience together. To illustrate, I describe select findings from the MIDUS (Midlife in the United States) national longitudinal study (see text Footnote 1), which is based on diverse probability samples, thereby facilitating analyses of how well-being and health vary by age, race, gender, and socioeconomic status. A counterpart study in Japan (MIDJA) has illuminated cultural differences in well-being and health. MIDUS has unprecedented depth in high quality measures of hedonic well-being (life satisfaction, positive, and negative affect), eudaimonic well-being (autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance), optimism, sense of control, personality traits, generativity, social responsibility, and social ties with spouse/significant other as well as parents during childhood. Deeply multidisciplinary in scope, MIDUS has facilitated linkage of all of the above variables to epidemiology, biology, neuroscience, and genetics. Most importantly, MIDUS data are publicly available and are widely used by scientists around the world.

Many findings have combined positive and negatives. For example, Morozink et al. (2010) showed that those with lower educational attainment had elevated levels of IL-6 (interleukin-6, an inflammatory marker implicated in numerous diseases) but higher psychological well-being buffered against such effects. Miller et al. (2011) showed that those from lower socioeconomic backgrounds had increased risk for metabolic syndrome in adulthood, but maternal nurturance buffered such risk. Resilience findings (see Ryff et al., 2012 ) showing that positive psychosocial factors afforded protection against poor health and physiological dysregulation in the face of various challenges (aging, inequality, early life adversity, cancer, loss of spouse). Breaking new ground, multiple studies have documented that higher purpose in life predicts increased length of life and better health behaviors ( Ryff and Kim, 2020 ). Regarding underlying mechanisms, Heller et al. (2013) showed that sustained activation of reward circuitry in the brain predicted higher eudaimonic well-being as well as better diurnal regulation of cortisol. Personality researchers have studied “healthy neuroticism,” with findings from multiple international studies showing that neuroticism is less strongly linked with poor health behaviors (smoking, inactivity) among those who are high in conscientiousness ( Graham et al., 2020 ).

With regard to race, MIDUS has advanced knowledge of the Black-White paradox in health ( Keyes, 2009 ) – i.e., despite inequality and discrimination, Blacks show higher levels of flourishing and lower levels of mental disorders than Whites. Keyes (2005 , 2007) also revealed neglected types of mental health in the general population by jointly examining mental distress (depression and anxiety) and well-being (emotion, psychological, and social). In contrast to those who are flourishing (high well-being and no mental distress) are those who are languishing, defined as not suffering from mental distress but having low well-being. Declining well-being over time also predicted increased subsequent risk of mental distress ( Keyes et al., 2010 ), while positive mental health predicted subsequent recovery from mental illness ( Iasiello et al., 2019 ). Space does not permit the details, but many findings from MIDUS and MIDJA have documented cultural differences in how emotion and well-being matter for health and biological risk ( Miyamoto and Ryff, 2021 ).

To reiterate, I include the above glimpse at MIDUS research is to underscore the need for greater interplay and exchange between the field of PP and much parallel science being done by those who do not view themselves as positive psychologists and are not publishing in journals aligned with PP or happiness.

Recent Work in Positive Psychology

This section first below examines select areas of research that represent forward progress of PP over the past two decades. Then I note recent evaluative overviews of PP from those within the field. Some of their concerns are elaborated in the next sections on what I see as problems within PP science: first, the promulgation of poor instruments for assessing well-being, and second, the reliance on largely privileged, homogeneous samples for conducting PP research.

Forward Empirical Progress

Whether the science of PP is moving constructively forward can examined in various ways. Rather than conduct a systematic review of empirical findings, I choose to focus on chapter-writing, mostly from 3rd Edition of the Oxford Handbook of Positive Psychology ( Snyder et al., 2021 ). Unlike journal articles, chapters allow authors to combine many advances on particular topics over time thereby offering a narrative overview of multiple findings. The book includes 68 chapters written by 153 authors, 86% of whom were from the United States.

In the study of emotion, multiple lines of progress are evident. The broaden and build theory continues to evolve by showing short- and long-term benefits of positive emotions in multiple domains, including thoughts, actions, stress, health, physiological and neurological connections ( Tugade et al., 2021 ). Studies of positive affectivity, a trait composed of different components (joviality, self-assurance, and attentiveness) have also progressed via linkages to other constructs (extraversion, happiness, and well-being) as well as psychological disorders, health, marital and job satisfaction, and cultural issues ( Naragon-Gainey and Watson, 2021 ). Positive affect has been linked to longer life, lower incidence of disease, better recovery from disease and better overall health ( Hunter et al., 2021 ), with calls for further work on mechanisms, culture, and technology. The emotional approach to coping (EAC) shows evidence on the intentional use of emotional processing and expression to manage adverse circumstances, such as infertility, sexual assault, diabetes, cancer ( Moreno et al., 2021 ), while calling for more work on interventions, including who benefits (which contexts).

Happiness studies have examined ways in which happy and unhappy people respond to social comparisons, make decisions, and reflect ( Boehm et al., 2021 ), along with strategies (experiments and activities) to improve happiness and formulation of underlying mechanisms. Veenhoven (2021) reviewed differences in happiness across nations and linked them to important questions about what governments can or cannot do to raise levels of happiness, thus reaching toward issues of public policy. A unified model of meaning in life was advanced, underscoring the need for conceptual integration in this growing area of science ( Steger, 2021 ). Positive aging was covered via multiple positive formulations that have been extensively studied, in some cases with interventions ( Nakamura and Chan, 2021 ).

Shifting to life outlooks, how the future is construed was covered with work on optimism showing that those who expect good things to occur have higher well-being, better health, and higher quality social ties, partly attributable to how they cope with adversity ( Mens et al., 2021 ). Detrimental consequences of hope were considered, while calling for greater work on the origins of hope and cultural issues. Hope, defined as the perceived ability to achieve desired goals via pathways and agency, was examined with a goal pursuit process model and linked to academic and athletic performance, health and well-being, social relationships, and work ( Rand and Touza, 2021 ). Resilience, the capacity for positive adaptation in the face of significant adversity, was examined in models that illuminated self-regulation skills, good parenting, community resources and effective schools ( Cutuli et al., 2021 ). Strategies for reducing risk, building strengths and mobilizing adaptive systems were future directions.

Positive mental health was covered with a thoughtful historical perspective and overview of current conceptualizations and measures ( Delle Fava and Negri, 2021 ), examined from life course and cultural perspectives. Illustrating methodological novelty, Tarragona (2021) considered the benefits of personal narratives and expressive writing on mental health and physical health (immune function and cardiovascular health), particularly in the context of trauma. Dominant approaches to mental health interventions (psychotherapy, counseling, and coaching) were examined for commonalities and differences in time perspectives, therapeutic strategies and recipients ( Ruini and Marques, 2021 ), while emphasizing the need for professional regulation and oversight.

Several chapters covered interpersonal themes. Attachment theory was presented as a framework for studying positive relationships ( Mikulincer and Shaver, 2021 ) via links between mental representations of attachment security and how they matter for diverse outcomes (health, social adjustment or interpersonal conflict, and personal growth). Relationship complexities were examined, underscoring both meaningful rewards and substantial risks of close social ties ( Gable and Maisel, 2021 ). They highlighted positive processes, involving positive emotions, intimacy, growth of self-concept, and benefits of sharing positive events. Past research on empathy was reviewed and emerging work on the neuroscience of empathy described ( Duan and Sager, 2021 ). How empathy relates to racial/ethnic diversity, multiculturalism, and social justice were future directions. Forgiveness was described in terms of the methods used and the differentiation of various antecedents, some intrapersonal (empathy, personality, attributions, and religion) and others interpersonal (closeness and conciliatory behavior) ( Tsang and Martin, 2021 ). Whether forgiveness is uniformly positive was considered.

Pawelski and Tay’s (2021) described efforts to connect PP to the humanities through new conceptual analyses and various interventions. Silvia and Kashdan (2021) examined curiosity and interest, framed as recognizing, seeking out, and preferring things outside one’s normal experience. How these tendencies matter for well-being is under study in the laboratory and everyday life. Courage, defined as facing personal risks in pursuit of worthy goals, was examined historically and via modern theory and measurement tools focused on volition, goals, and risk ( Pury et al., 2021 ). Humility, formulated as accurate and modest self-presentation and being other-oriented, showed steady progress in empirical findings from 2000 to 2015 ( Worthington et al., 2021 ).

In sum, considerable evidence reveals forward progress on important topics in PP. Even though most areas of inquiry predated PP, it is useful to bring such contributions together to convey the range and diversity of topics on adaptive human functioning. At the same time, several chapters in the collection were not current in coverage, and some had a paucity of empirical findings. All ended with future questions. An interesting question is whether these have evolved over the past 20 years, or are largely similar to where the field was back then. Before addressing problematic areas of PP science, I next examine evaluative reviews from within the PP field.

Overarching Concerns About Positive Psychology

Lomas et al. (2021) call for PP to broaden toward complexity – go beyond the individual toward analysis of groups, organizations, and broader systems as well as to embrace diverse methodologies. Better understanding of context (historical, social, cultural, and institutional) was also emphasized. Contextual approaches were illustrated with positive organizational scholarship ( Cameron et al., 2003 ), positive educational approaches in schools ( Waters et al., 2010 ), and family-centered positive psychology ( Sheridan et al., 2004 ; Henry et al., 2015 ). Lomas et al. (2021) called for greater ethical oversight of the ever-expanding cadre of PP practitioners from applied programs: “…unless practitioners are affiliated to a particular profession, they may be operating outside the advice and provisions of any set of ethical guidelines” (p. 16).

Kern et al. (2020) contrasted the rapid growth of PP with concern about exaggerated claims, inflated expectations, disillusionment, and possibly, unintentional harms. Issues of over-promising and under-delivering in programs with individuals, schools, the workplace, and communities were noted. To help the field mature, they advocated for systems informed PP, which would clarify epistemological, political, and ethical assumptions and commitments. The implications of such ideas for research and practice were examined.

van Zyl (2022) reviewed criticisms and concerns about PP, including the lack of a unifying metatheory that underpins the science as well as fundamental ideas for how positive psychological phenomena should be researched. Related criticisms were that PP has borrowed most of its theories from social, behavioral and cognitive psychology, thereby advancing few of its own unique perspectives. There is the problem of terminological confusion – e.g., using terms like flourishing or well-being interchangeably when operationalizations of them are notably different, or failing to recognize the possible overlap among putatively distinct topics, such as grit, conscientiousness, or diligence. Inconsistency in the factorial structures of various measurement models is a further problem. The fact that most PP has failed to produce significant or sustainable changes was noted, along with its cultural (Western) biases.

Taken together, I agree with most of the above assessments and further illustrate them below.

Problems in Positive Psychology Science: Flawed Conceptualization and Measurement of Well-Being

I bring my expertise in the study of psychological well-being to how some have approached this topic in PP. As noted above, I foresaw problems of measurement clutter at the dawning of PP ( Ryff, 2003 ). My prediction was prescient and needs attention, given growing interest in the measurement of well-being across scientific disciplines. A recent edited volume ( Lee et al., 2021 ) included scrutiny of multiple measurement approaches along with an animated exchange among contributors ( Ryff et al., 2021a , b ; VanderWeele et al., 2021a , b ) on the pluses and minuses of various assessment strategies. What came into high relief was concern about the proliferation of thin, poorly validated measures that are undermining quality science in the study of well-being.

Although not considered in the above volume, Seligman and his collaborators have contributed to this problem. I offer two examples of the promulgation of poorly constructed and poorly validated measures of well-being that are at odds with claims that PP rests on rigorous science. A first study ( Seligman et al., 2005 ) sought to validate five different interventions (gratitude visit, three good things, you at your best, using signature strengths in a new way, and identifying signature strengths). Internet-based samples were recruited through the authentic happiness website 2 ; most participants were white and highly educated.

All completed baseline assessments and five follow-up assessments over a 6-month period after completion of the intervention assignment. As a general observation, the findings were overstated – most comparisons between the control group and intervention groups were not significantly different across time, nor was there coherence in when such effects were evident. There was also insufficient attention given to pre–post comparisons, which are central for demonstrating intervention effectiveness. My primary focus, however, is on the outcomes assessed – specifically, the measure of happiness.

Described as “scientifically unwieldy” (p. 413) happiness was “dissolved” into three distinct components: “(a) positive emotion and pleasure (the pleasant life), (b) engagement (the engaged life), and (c) meaning (the meaningful life).” I note the redundancy in defining each component. The source for this tripartite formulation was Seligman’s (2002) trade book, Authentic Happiness , which was operationalized with the Steen Happiness Index (SHI), an unpublished 20-item inventory. No evidence was provided that the inventory measures three distinct components of well-being, nor is it likely such evidence could be assembled. Many items lack face validity – i.e., they pertained to other constructs, such as optimism, positive self-regard, frustration, energy, social connection, making good choices. Adding to the befuddlement was this statement: “We continue to use the word happiness, but only in the atheoretical sense of labeling the overall aim of the positive psychology endeavor and referring jointly to positive emotion, engagement, and meaning” (p. 413). All analyses focused the atheoretical construct of happiness – i.e., the component parts were nowhere to be seen.

Next came PERMA, defined by Seligman (2011) in Flourish , another popular book. Added to the prior components of positive emotion, engagement, and meaning, were now two additional components: relationships and accomplishment. Again, none were explicitly defined, nor was the pronouncement about what happiness entails theoretically grounded in anything , nor was it linked with the extensive prior empirical literatures on subjective and psychological well-being as well as research on positive emotions (exemplified by the diverse MIDUS measures). Such obliviousness to what the field had been investigating for decades made inevitable that there would be redundancy with already validated approaches and assessment tools. Such duplication became a certainty given how PERMA was operationalized – namely, by taking items from prior instruments ( Butler, 2011 ). These were transformed into the PERMA-Profiler ( Butler and Kern, 2016 ) via multiple studies (none clearly defined) involving a large samples recruited mostly through online systems; most participants were well-educated.

Missing from the reported analyses were key preliminaries required to develop quality assessments. For example, of central importance was whether the item pools for the five components were empirically distinct (i.e., did each item correlate more highly with its own scale than another scale?). In subsequent tests of convergent validity with other measures, a further problem, not addressed, was the degree of item-overlap (redundancy), given that all PERMA items came from prior instruments. Additional analyses correlated PERMA scales with 20+ measures. For many (e.g., organizational practices, political orientation, work performance, social capital, burnout, values, self-efficacy, perceived stress, and gratitude), the relevance of these analyses was unclear.

Subsequent work showed that PERMA and subjective well-being are indistinguishable ( Goodman et al., 2018 ). Seligman (2018) responded by calling for the need to “transcend psychometrics,” accompanied by an exegesis on the psychometrics of baseball pitching. Also offered was the observation that “SWB probably is the useful final common path of the elements of well-being” (p. 1) – presumably an effort to deflect evidence away from the clear empirical redundancy of PERMA with subjective well-being. Most incoherent was the following: “All of this is to say that a good theory of the elements of well-being helps to build well-being and that the psychometric findings that the elements correlate perfectly with overall well-being and that the elements correlate very well with each other is not very instructive when it comes to building well-being” (p. 2).

Other findings have shown questionable support for the putative five-factor structure of PERMA ( Watanabe et al., 2018 ; Ryan et al., 2019 ; Umucu et al., 2020 ). Data from German speaking countries Wammerl et al. (2019) supported for the five-factor model but also bifactor models ( Reise, 2012 ). My observation is that these latter methodological studies examining various multivariate structures are largely disconnected from substantive issues of what well-being is, or critical questions needed to advance the field. Those are not about dimensional structures of recycled items, but about the antecedents and consequents well-being, whether well-being is protective in the face of adversity, and whether interventions can promote well-being. On all of these questions, the above two efforts to articulate a meaningful, conceptually grounded theory of happiness that works empirically (i.e., the data support the claimed multifactorial structure) AND that is distinct from what was already in the field, have failed.

Problems in Positive Psychology Science: Samples and Contexts

A second major problem in PP research, already illustrated in preceding sections, is the overwhelming reliance on homogeneous, privileged samples . This lack of diversity pervades subfields of psychology that have tended to conduct their research with readily available college students or community volunteers. Others call this the WEIRD phenomenon ( Henrich et al., 2010 ) – doing research with western, educated, industrialized, rich, and democratic societies. Minorities and socioeconomically disadvantaged individuals are missing in such inquiries, although population research makes clear that well-being and health are linked with sociodemographic factors ( Ryff et al., 2021c ). Our review, which included findings from MIDUS and other large studies, made clear that numerous aspects of well-being (hedonic and eudaimonic) do, in fact, differ by age, socioeconomic status, race, and gender. These differences also predict diverse health outcomes, assessed in terms of symptoms, chronic conditions, biological risk factors, and mortality. Thanks to the MIDJA (Midlife in Japan) study, we have illuminated cultural differences in many of these same topics ( Miyamoto and Ryff, 2021 ).

Closer to PP, I note that Frontiers in Psychology issued a recent call for papers to address with PPI (positive psychology interventions) work in non-WEIRD contexts ( van Zyl et al., 2021 ). Their bibliographic analyses showed that only about 2% of PPIs to date have been conducted with vulnerable groups, or in multi-cultural contexts. Clearly, a major need going forward is the importance of reducing the bias toward Western (often United States) samples of privileged people whose lives are clearly not representative of those from other cultural contexts as well as focusing on disadvantaged groups within such contexts.

The Commercialization of Positive Psychology: Needed Oversight

It is without question that PP has become a big business ( Horowitz, 2018 ). Happiness promotion involves billions of dollars spent on popular books, workshops, counseling/coaching, apps, websites, and social media platforms. PP has entered the corporate world through happiness consulting companies that claim to “bridge the gap between cutting-edge research in the field of positive psychology and best practices within corporate and community cultures around the globe” (p. 244). Horowitz wryly observes that few promoting happiness as the route to success consider the alternative – i.e., that success leads to happiness. There is also a marked failure to address the needs of lower echelon workers, such as better wages and benefits. Instead, motivational speakers cheer on executives, managers and workers with messages consonant with positive psychology and neoliberalism. Via apps and other gadgets happiness has become a “measurable, visible, improvable entity” (p. 246), thus replacing global commitments to combat stress, misery, and illness was with relaxation, happiness, and wellness.

I will not detail the dizzying array of websites promoting happiness, flourishing, and positive psychology; they are easily found online. Instead, I ask whether the for-profit cart has gotten seriously ahead of the scientific horse. This is a matter the scientific community cannot afford to ignore because it addresses whether the evidential basis behind the proliferation of products is truly there, or has been glossed over in the frenzy to sell. Prior to the commercialization of PP, scientists had shared understanding of what is required to demonstrate intervention effectiveness, as in randomized clinical trials, a staple of the National Institutes of Health. These guidelines exist to protect the public from products that are not credible. That the advertised promise of happiness promotion may be overstated is intimated by the “Earnings Disclaimer and Statement of Individual Responsibility” from the Flourishing Center 3 . It states that “the Flourishing Center, Inc. makes no guarantees that you will achieve results similar to ours or anyone else’s.” Additional text in this format follows: YOU FULLY AGREE AND UNDERSTAND THAT YOU AND YOU ALONE ARE RESPONSIBLE FOR YOUR SUCCESS OR FAILURE. NO REFUNDS ARE AVAILABLE UNLESS STATED OTHERWISE ON A PROGRAM’S SALES PAGE.

Closer to the heart of PP, we need to ask what it means when character strengths are being sold, when virtue has become a commodity, and when PP scientists have shopping carts on their websites. There is also the matter of pricing. Horowitz (2018) describes some who are receiving $25,000 speaker fees – are these defensible in academia? Many believe we have a responsibility to share our knowledge and expertise, but not to do so in pursuit of personal profit. Scrutiny also is required regarding the content of educational programs. Here I focus on the flagship program that is presumably leading the field – namely, the Master’s in Applied Positive Psychology (MAPP) at the University of Pennsylvania, described with no shortage of hubris, as Medici II ( Seligman, 2019 ). MAPP offers two semesters (nine courses) and a summer capstone project for a price of over $70,000. The curriculum is thinly described on the website, but if students are being taught that the theory, history, and meanings of PP (Introduction to Positive Psychology) began with Seligman and Csikszentmihalyi (2000) and other foundational documents ( Pawelski, 2016 ), they are not getting what they paid for. Further, if PERMA is being taught as a credible tool for measuring well-being (Research Methods and Evaluation), they are being miseducated. The theoretical, empirical, and experiential nature of positive interventions (Foundations of Positive Interventions) are not detailed on the website, but if Seligman et al. (2005) , reviewed above, is presented as credible evidence that PP interventions work, they are being misled.

Amidst these questions, it is important to underscore that high quality teaching materials for such programs do exist, such as the recent book on Positive Psychology Through the Life Span: An Existential Perspective ( Worth, 2022 ) and another on Positive Psychology in the Clinical Domains ( Ruini, 2017 ). Both offer thoughtful, historically comprehensive perspectives in their respective domains, which are essential features of quality education in PP.

The larger issue is the quality of what PP is marketing, not just in master’s programs, but also certificate programs and short-term seminars. Horowitz (2018) notes those who have expressed concerns about ethical oversight, calling for standardized nomenclature, formal training and certification guidelines, given uneven credentialing among those doing this work. Central concerns are whether the teaching in some programs is superficial and short-term practices lack scientific evidence of effectiveness. Stated otherwise, the commercialized end of PP appears to be fundamentally unregulated. “Despite all the research carried out in the field, what remains too often neglected are the who, why, and with what results ordinary consumers gain from all the money and time they spend on pursuing positive psychology by reading books, attending workshops, and carrying out recommended exercises.” (Horowitz, p. 274).

Looking Forward: Suggested New Directions for Positive Psychology

Societal ills as research imperatives.

Two major challenges of our era, ever-widening inequality and the world-wide pandemic, need scientific attention. Together, they constitute intersecting catastrophes ( Ryff, forthcoming ). Among those who were already disadvantaged, the pandemic has aggravated difficulties many were already facing plus added new challenges (unemployment, loss of healthcare, evictions due to unpaid rent, and food lines/hunger). MIDUS has been a prominent forum for investigating health inequalities, given its rich psychosocial, behavioral, and biological assessments ( Kirsch et al., 2019 ). Our findings have linked lower education and incomes to compromised well-being, greater psychological distress, poorer health behavior, higher stress exposures, elevated biological risk factors, greater morbidity and earlier mortality (see Text Footnote 1). A unique feature of the study has been recruitment of two national samples situated on either side of the Great Recession. Over the period covered by these two samples, educational attainment in the United States improved.

Despite such educational gains, the post-Recession refresher sample reported less household income (after adjusting for inflation), lower financial stability, worse health (multiple indicators) and lower well-being (multiple indicators) than the pre-Recession baseline sample. Further work compared the two samples on measures of negative and positive emotions, showing more compromised mental health in the later refresher sample, particularly among those with lower socioeconomic standing (measured with a composite of education, occupation, income, and wealth) ( Goldman et al., 2018 ). This worsening of mental health among disadvantaged Americans has occurred in the context of the opioid epidemic, growing alcoholism and increased death rates, including suicide, among middle-aged white persons of low SES standing ( Case and Deaton, 2015 ; Kolodny et al., 2015 ; Grant et al., 2017 ; Schuchat et al., 2017 ), a phenomenon known as deaths of despair ( Case and Deaton, 2020 ).

Positive psychologists need to engage with these societal changes. I note promising work already underway ( Waters et al., 2021 ). Although human strengths constitute important protective resources in the face of adversity, it is also the case that significant challenge can sometimes disable pre-existing strengths ( Shanahan et al., 2014 ). We found evidence of such disablement among those exposed to high levels of hardship in the Great Recession ( Kirsch and Ryff, 2016 ). Going forward, it is critical that studies of psychological strengths in the face of pandemic stress include assessment of key sociodemographic variables such as socioeconomic status in national samples. Vazquez et al. (2020) illustrated such work in a representative sample of Spanish adults. It is critical that future PP contributions to understanding impacts of the pandemic not perpetuate the longstanding prior focus on privileged, homogeneous samples.

Neglected Negatives Behind the Current Societal Problems

The founders of PP advocated that psychology should encompass more than psychopathology (depression and anxiety) and other forms of dysfunction. Hence, the call to elevate positive aspects of human functioning. I observe that psychology as a discipline has neglected something else: namely, a category of negative characteristics that may be implicated in the societal problems we now face. These include greed, indifference, and stupidity ( Ryff, 2017 , 2021a ), along with anger, which is not inherently positive or negative. I cover these topics below because they reveal a possibly pernicious blind spot in the larger vision of PP: namely, that the well-being and positive human functioning of some (especially those who are disadvantaged) may be compromised by the priorities and actions of others (especially those who are advantaged). To the extent that PP ministers primarily to the better educated and economically comfortable in conveying how to get the most out of life and achieve personal potential, PP may, itself, be part of the problem.

To illustrate, I note the widespread marketing of mindfulness meditation, including to CEOs as described by Horowitz (2018) in Happier? Purser (2019) offers more, observing that “mindfulness programs do not ask executives to examine how their managerial decisions and corporate policies have institutionalized greed, ill will, and delusion. Instead, the practice is being sold to executives as a way to de-stress, improve productivity and focus, and bounce back from working 80-h weeks. They may well be ‘meditating,’ but it works like taking an aspirin for a headache. Once the pain goes away, it is business as usual. Even if individuals become nicer people, the corporate agenda of maximizing profits does not change.”

Following from the above quote, we must consider that among the malevolent forces contributing to ever-widening inequality are behaviors of excessive self-interest orchestrated by those in positions of power. These problems are empirically evident when corporate profits soar, but worker paychecks lag ( Cohen, 2018 ), a problem described by economists as “monopsony power” – the ability of employers to suppress wages below the efficient or perfectly competitive level of compensation ( Kruger and Posner, 2018 ). Human history shows longstanding concern about problems of greed. The ancient Greeks saw greed and injustice as violating virtues of fairness and equality, and thereby, contributing to civic strife ( Balot, 2001 ). Dante’s Divine Comedy ( Dante’s, 1308/2006 ) placed sins of greed and gluttony, along with fraud and dishonesty, in his nine circles of hell. Adam Smith’s Wealth of Nations ( Smith’s, 1776/1981 ) made the case for self-interest and capitalism, but recognized the problem of greed, framed as the limitless appetites of the vain and insatiable.

Some within psychology are addressing what lies behind the worship of money and selfish wealth gratification, sometimes orchestrated through fraudulent tactics ( Nikelly, 2006 ). Motivational psychologists have studied “the dark side of the American Dream” ( Kasser and Ryan, 1993 ), showing that those motivated by primarily extrinsic factors (financial success) have lower well-being and adjustment compared to those motivated by less materialistic values. Social psychologists have shown that those with higher social class standing have increased sense entitlement and narcissism compared to those from lower class backgrounds; those in the upper-class are also more likely to behave unethically than those in the lower-class ( Piff et al., 2012 ; Piff, 2013 ). A large study of United States students examined what lies behind the widespread acceptance of inequality ( Mendelberg et al., 2017 ) by asking them to indicate their agreement or disagreement with the statement: “Wealthy people should pay a larger share of taxes than they do now.” The main finding was that students from affluent colleges (defined by family SES background) were more likely than those from public or less affluent colleges and universities to disagree with the statement – i.e., the most privileged were also the most strongly opposed to having the wealthy pay more taxes. In addition, such tendencies were most pronounced among those who were active in college fraternities and sororities.

The seamy underside of philanthropy, usually thought of as elites doing good in the world, is also under scrutiny ( Giridharadas, 2018 ). The Sackler family, well-known for their philanthropy in art museums around the world, offers a singular example. They owned Purdue Pharma, which created oxycontin, the highly addictive opioid painkiller that was aggressively marketed, thereby leading to massive over-prescribing. To date, more than 500,000 have died from overdose deaths. A 2021 HBO documentary, Crime of the Century , revealed the widespread individual actions behind this public health tragedy – within drug companies, political operatives, and government regulators, all of whom backed the reckless distribution of this deadly, but highly profitable, drug.

Some might argue that the above examples are isolated actions of those of extreme wealth and do not represent most of the rest of us. Stewart’s (2021) recent look at the new American aristocracy suggests otherwise. With a solid evidential basis, he shows that a much larger segment of the population is involved in warping our culture – i.e., how those laser-focused on career success are relying on an underpaid servant class to fuel their forward progress, while also making personal fitness a national obsession, even as large segments of the population lose healthcare and grow sicker. The privileged also segregate themselves in exclusive neighborhoods and compete relentlessly in getting their children into elite schools, which has contributed to ever-more extreme costs of higher education. Perhaps most troubling is the ethos of merit they have created to justify their advantages. Stewart powerfully distils that these people are not just around us, they are us.

Indifference

On this topic I have little to say other than to quote Elie Wiesel, Nobel Prize winning author and Holocaust survivor: “I believe that a person who is indifferent to the suffering of others is complicit in the crime. And that I cannot allow, at least not for myself. The opposite of love is not hate, it’s indifference.” In the present era, such indifference to the widespread suffering of others must be studied and documented. It is a character weakness that psychologists should try to understand – where does it come from? How is it enacted? What are its consequents?

Marmion’s (2018) tongue-in-cheek edited collection on the Psychology of Stupidity warrants consideration, given psychology’s long preoccupation with studying intelligence (of multiple types) and cognitive capacities (also of multiple types). The book offers a taxonomy of morons and links stupidity with established topics (cognitive bias, narcissism, and negative social networks). Wisely, Marion asserts: “No matter what form it takes, stupidity splatters us all. Rumor has it that we ourselves are the source of it. I am no exception” (p. ix). The kind of stupidity that most interests me and needs critical study is the swallowing of lies, or being duped by others. Lies are perpetrated by people in high or low places, but the essential question is why they have impact – why they are believed. Some in the clinical realm have examined such questions, focusing on those who lie with impunity, sometimes revealing clear sociopathy ( Peck, 1983 ; Stout, 2006 ). We need more science about these assaults on the truth and why they have become such pervasive part of contemporary life. My hypothesis is that all levels of human experience (personal ties, the workplace, communities, and societies) are damaged by the swallowing of lies, whether knowingly or unknowingly.

Often depicted as toxic, anger is sometimes legitimate as Aristotle understood. He reminded that at the right time, to the right degree, and for the right reasons, anger can be a powerful and needed response. Indeed, its neural underpinnings look more like positive affect than depression or anxiety ( Harmon-Jones et al., 2011 ). Anger may be uniquely justified vis-à-vis profoundly unequal life opportunities. Mishra’s Age of Anger ( Mishra’s, 2017 ), offers an astonishing integration of history, philosophy, literature, politics, economics, and cultural studies on the topic. He begins with this: “Individuals with very different pasts find themselves herded by capitalism and technology into a common present, where grossly unequal distributions of wealth and power have created humiliating new hierarchies. This proximity is rendered more claustrophobic by digital communications and the improved capacity for envious and resentful comparison” (p. 13). Drawing on Arendt, Mishra describes existential resentments that are poisoning civil society and fueling authoritarianism.

Most powerful is Mishra’s portrayal of the distinct philosophies of Rousseau and Voltaire, eighteenth century interpreters of life. Voltaire praised material prosperity and consumerism, boldly professing his love of conspicuous consumption. Rousseau reminded that the ancients spoke incessantly about morals and virtue whereas the French philosophes spoke only of business and money. He saw the new commercial society as acquiring features of class division, inequality, and callous elites whose members were corrupt, hypocritical and cruel. According to Mishra: “What makes Rousseau, and his self-described ‘history of the human heart,’ so astonishingly germane and eerily resonant is that, unlike his fellow eighteen-century writers, he described the quintessential inner experience of modernity for most people: the uprooted outsider in the commercial metropolis, aspiring for a place in it, and struggling with complex feelings of envy, fascination, revulsion, and rejection” (p. 90). Although Rousseau’s books were best sellers in his era, they are rarely invoked in current discourse. He castigated the Enlightenment philosophes for their self-love and self-interest, writing that amour propre ( McLendon, 2009 ) was a dangerous craving to secure recognition for self over others and an insatiable ambition to raise personal fortunes. These observations need serious examination vis-à-vis the thriving business of PP – to what extent are self-interest and personal ambition the central motives behind what is being sold?

Returning to empirical science, I note that MIDUS includes multidimensional assessments of anger, from over 20 publications have been generated (see Text Footnote 1). Anger expression has been linked to multiple indicators of health (sleep, cognitive function, inflammation, and allostatic load) as well as to race/ethnicity, socioeconomic status, early life adversity, and cultural context.

What Nurtures Our Better Selves: The Arts and Humanities

To those who find my views to be overly negative, I end this section with more hopeful topics. I note that my career journey has reflected this dual focus on the forces that both undermine as well as nurture positive psychological functioning ( Ryff, 2022 ). As stated at the outset and multiple times long the way, I have always believed both are fundamental parts of the human experience. I begin this part with distant observations from Matthew Arnold, who in Culture and Anarchy ( Arnold, 1867/1993 ), emphasized that freedom should be employed in the service of higher ideals and further noted that these ideals are critically important during times of great peril, such as pandemics and wars. For him, culture was the study of perfection tied to the moral and social passion for doing good.

I have long believed that the arts (broadly defined) and humanities (history and philosophy) can help us discern how to do good and be well ( Ryff, 2019 ). Growing research is now linking diverse art (music, literature, poetry, art, film, and dance) to health ( Fancourt, 2017 ; Fancourt and Finn, 2019 ). To maintain a thread to current societal challenges, I here consider the arts in a somewhat different way – namely, whether they might be venues for nurturing compassion and insight about human suffering, which has become so widespread. Starting with contemporary film, multiple examples (e.g., The Florida Project, American Honey, Paterson, Parasite , and Nomadland ) reveal the lived experience of inequality, including descending into prostitution to feed a child, growing up with addicted parents, having dreams of self-realization stymied, experiencing homelessness, and working in physically-difficult, mind-numbing jobs. These works also portray the poetry in disadvantaged lives, including cleverness and resourcefulness vis-à-vis insensitive elites. The relevance of these domains for contemporary science, largely unstudied, is whether such inputs increase quotients of caring and compassion, and possibly challenge the complacency and indifference among those who are not suffering. Such questions elevate themes of social justice in ongoing research on well-being and health, while pointing to the arts as possible venues for informing and mobilizing individual and societal action.

The visual arts may also powerfully activate compassion vis-à-vis the pandemic or contemporary conflicts. The self-portrait of the Austrian artist, Egon Schiele, painted in 1912 and looking gravely ill before his death at age 28 from the Spanish flu, which also took his wife and their unborn child, is an example. Kandinsky painted Troubled in 1917, an abstract work of turbulence and trauma created during the Russian revolution when he was lived in Moscow and had a child die of malnourishment. A last visual example comes from over 1,000 watercolors painted from 1940 to 1942 and brought together in Charlotte Salomon: Life? Or Theater? ( Salomon, 2017 ). Born in 1917, this woman experienced multiple suicides in her family during her brief lifetime. She was a student at the Berlin Fine Arts Academy and in 1938 fled to southern France where an intense period of creativity unfolded. Next to a series of paintings depicting multiple faces with dramatic eyes and sad countenances, she wrote: “I realized that no heaven, no sun, no star could help me if I did not contribute by my own will. And then I realized that actually I still had no idea who I was. I was a corpse. And I expected life to love me now. I waited and came to the realization: what matters is not whether life loves us, but that we love life.” This insight about loving life had tragic salience: she was transported to Auschwitz in 1943 where, at age 26 and 5 months pregnant, she died.

Literature is another powerful realm for revealing travesties of the human condition. In A Tale of Two Cities ( Dickens, 1859/2004 ), Charles Dickens brought horrors of the French Revolution to the hearts and minds of his readers. We learned of the awful lives of those imprisoned within the Bastille, and after it was stormed, the executions by guillotine at the Place de La Concorde in Paris. The bloodbath of class retribution took more than 1,200 lives, including the French Queen and King. Here is how Dickens described the context: “…the frightful moral disorder born of unspeakable suffering, intolerable oppression, and heartless indifference” (p. 344). At the core of the book is Madame DeFarge, the tigress quietly knitting, observing, and overseeing the acts of vengeance. Near the end, we have insight into her fury, learning that her younger sister was the victim of shameless male aristocrats who carelessly exploited her and destroyed her life and family.

Two contemporary books of fiction address the current migration crisis. Mohsin Hamid’s Exit West ( Hamid’s, 2017 ) describes the awful realities of refugees whose lives have been stolen out from under them, only to be subjected to endless trauma as they try to find another home. Another recent work, Call Me Zebra ( Van der Vliet Oloomi, 2018 ), winner of the 2019 PEN/Faulkner award for fiction, tracks a family escaping from Iran by foot. The mother dies along the way, but the father and daughter eventually make their way to New York. The family is a group of anarchists, atheists, and autodidacts who took refuge in books; their distilled philosophy: “Love nothing except literature, the only magnanimous host there is in this decaying world…. The depth of our knowledge, the precision of our tongues, and our capacity for detecting lies is unparalleled” (p. 8). Memorization is key; thus, sprinkled throughout the book are quotes from Nietzsche, Omar Khayyam, Dante, Goethe, Rilke, Kafka, Cervantes, Garcia Lorca, Dali, and Picasso – “These writers’ sentences deposited me at the edge of the unknown, far from the repulsive banality of reality others refer to as life” (p. 205).

I conclude with examples of satire vis-à-vis experiences of oppression and want. Jonathan Swift’s, A Modest Proposal , written in Swift’s (1729) , was put forth with the stated intent of preventing the children of the poor people in Ireland from being a burden to their parents or the country, as well as to make them beneficial to the wider public. Swift began by describing female beggars in Dublin followed by their many children, all in rags, importuning every passing person for alms. He elaborated on the numerical scope of the problem and then observes that these young children cannot be fruitfully employed until they are around age twelve. Swift thus suggests that these children, if well nursed for their first year, be sent to England to provide “a most delicious nourishing and wholesome food, whether stewed, roasted, baked, or boiled; and I make no doubt that it will equally serve in a fricassee, or a ragout” (p. 3). Calculations were included to show the financial benefits that would follow. This satirical hyperbole mocked the heartless attitudes toward the poor among the British as well as their policies toward the Irish in general. The book is widely recognized as one of the greatest examples of sustained irony in the history of the English language.

Moving to the present, Paul Beatty’s The Sellout ( Beatty’s, 2015 ) won the Man Booker Prize and was praised as “Swiftian satire of the highest order.” The book covers race relations in the fictional township of Dickens (meaningfully named), California, a place where residents are left to fend for themselves. With masterful humor, Beatty parodies everything – from contemporary psychology to “slapstick racism” to public transportation to depict the obstacles of being poor and black in racist America. Sister cities for Dickens are identified: Chernobyl, Juárez, and Kinshasa – all known for their pollution, poverty, and dysfunction. The satire and razor-sharp wit reveal what it means to exist in a culture saturated with negative stereotypes.

To summarize, I have emphasized the role of the arts in awakening the wider public to human suffering. Central questions for science and praxis are whether these inputs can effectively increase needed supplies of compassion and empathy, while perhaps also provoke awareness of complacency among those who are comfortable, if not indifferent. Such topics can and should be studied, including in experimental and educational contexts. The National Endowment for the Humanities regularly tracks who partakes of the arts and further shows variation therein by educational status. Such practices are fundamentally not different from studying health behaviors (smoking, drinking, and exercise). These parts of living, focused on the content of what people are taking in, need to part of large epidemiological studies, where they could be linked with other important topics such as reported levels of social responsibility and caring ( Ryff and Kim, 2020 ) as well as their views about who should be taxed at what levels ( Mendelberg et al., 2017 ).

What Nurtures Human Flourishing: The Natural Environment

Nature is powerfully present in the visual arts and music as well and has been throughout human history. I have recently covered these topics elsewhere, including nature’s role in nurturing the human spirit ( Ryff, 2021b ) and here highlight some of that work. My overall messages are that those interested in understanding influences that nurture good lives as well as a concern for our planet need to bring encounters with nature into their scientific studies, including interventions designed to promote diverse aspects of well-being and health.

Vibrant research is now investigating how nature contributes to human flourishing ( Capaldi et al., 2015 ; Mantler and Logan, 2015 ). These ideas take on greater salience as more of the world’s population live in nature-impoverished urban milieus. Multiple theories have been invoked to explain how we benefit from nature, such as the biophilia hypothesis from evolutionary thinking, which suggests that our human ancestors depended on connecting with nature to survive ( Kellert and Wilson, 1993 ), or stress-reduction theory ( Ulrich et al., 1991 ), which proposes that past exposures to unthreatening natural environments contributed to survival via stress-reducing physiological responses. Other perspectives consider roles of the natural environment in addressing existential anxieties, such as meaning in life, isolation, freedom, and death ( Yalom, 1980 ). Eco-existential positive psychology ( Passmore and Howell, 2014 ) thus describe how restorative experiences with nature might contribute to sense of identity, multiple forms of happiness, meaning, social connectedness, freedom, and awareness of one’s mortality.

Empirical evidence has linked encounters with nature to high hedonic well-being, both short and long-term, and to aspects of eudaimonic well-being ( Capaldi et al., 2015 ; Mantler and Logan, 2015 ; Triguero-Mas et al., 2015 ). Some inquiries have examined intervening mechanisms, such as increased physical activity, increased social contact, stress reduction and restoration of cognitive attention. The focus on green spaces underscores growing concerns about urbanization, loss of biodiversity, and environmental degradation. Increasingly dire consequences of climate change (droughts, wildfires, and floods) have also led to research on pro-nature behaviors that support conservation of nature and biodiversity. Richardson et al. (2020) conducted an innovative population survey in the United Kingdom examining links between pro-nature actions with time spent in nature as well as knowledge of and concerns about nature.

Nature as a source of inspiration and uplift is pervasively present in poetry, literature, music, art, history, and philosophy. An example is the life of Alexander von Humboldt (1769-1859), beautifully written about in The Invention of Nature ( Wulf, 2016 ). Primarily a scientist, naturalist, and explorer (of South America and Siberia), Humboldt influenced many of the great thinkers of his day, including Jefferson, Darwin, Wordsworth, Coleridge, Thoreau, and Goethe. Humboldt was ahead of his time in thinking about the degradation and exploitation of nature, warning that humankind had the power to destroy the natural environment, the consequences of which would be catastrophic. He wanted to excite a ‘love of nature’ and thereby, revolutionized how the natural world was seen. He believed that nature speaks to humanity in a voice “familiar to our soul” (p. 61), thereby aligning himself with the Romantic poets of his time who believed nature could only be understood by turning inward.

The educator Mark Edmundson uses great literature and poetry to nurture well-being, including the ideals needed by the human soul such as courage, contemplation, and compassion ( Edmundson, 2015 ). In Why Read ( Edmundson, 2004 ). Edmundson elaborates what a liberal, humanistic education can contribute to personal becoming. Apropos of Humboldt and his contemporaries, Edmondson examined Wordsworth’s famous poem, “Lines Composed a Few Miles from Tintern Abbey” written in 1798. Wordsworth’s life had become flat – “he lived in a din-filled city, among unfeeling people, and sensed that he is becoming one of them …there is a dull ache settling in his spirit” (p. 57). Returning to a scene from his childhood, he remembered himself as a young boy, free and reveling in nature. The return to nature, which is the heart of the poem, reminds him of its role in nurturing his own vitality. “Wordsworth’s poem enjoins us to feel that it (the answer to one’s despondency) lies somewhere within our reach – we are creatures who have the capacity to make ourselves sick, but also the power to heal ourselves” (p. 49).

Wordsworth’s poetry served the same vital function in the life of John Stuart Mill (1893/1989) , who in early adulthood realized something deeply troubling – that he lacked the happiness central to the utilitarian philosophy in which he was immersed. Reflecting on his life, Mill described an early educational experience that was exceptional, but profoundly deficient. His father began teaching him Greek and Latin at a young age and then expanded the pedagogy to fields of philosophy, science, and mathematics. However, his father was deeply opposed to anything connected to sentiment or emotion. To escape the logic machine he had become, Mill began a quest to feel, and it was the poetry of Wordsworth, mostly about nature, that ministered deeply to the longings in his soul. He credited it for helping him recover from the crisis in his mental history.

To summarize, amidst the many interventions under study in PP, I lobby for a focus on encounters with nature, which some are already investigating. The preceding examples give us reason to believe that human lives may be enriched by such experiences. These can occur by being in nature as well as from reading about nature in poetry and literature, taking it in through film, or listening to music inspired by nature.

Concluding Thoughts

My observations about what PP has accomplished over the last two decades are clearly mixed. Some may see the criticism as unfounded, if not mean-spirited, while others may view the input as long overdue straight talk about problems with an initiative intended to be transformational. I have long believed that self-criticism is central to making progress, whether in our individual lives, or our collective pursuits. My hope is thus that the field of PP will grow and flourish going forward, but also come to grips with its limitations. How might this happen?

One way is to pay attention to the problem of overreach in what PP claims to have accomplished. This will require greater scrutiny of the science touted as the evidential basis that PP works. Peer review is all we have to monitor the quality of the work that we do, but alas, it is an imperfect system, such that seriously flawed work sometimes gets published, even in high visibility outlets. There is the related problem of PP taking credit for more than it can credibly call its own achievements – i.e., the impact of PP ( Rusk and Waters, 2013 ) has been overstated. As conveyed at the outset, extensive science on positive human functioning was happening well before PP declared its visionary new path. The upshot is that quantitative summaries of positive science unavoidably include many products that have nothing to do with the field of PP. Work from MIDUS is but one example of such wide-ranging science, much published in top-tier journals, showing protective benefits of psychological strengths. These studies were not created or nurtured by PP, and therefore, do not constitute evidence of its impact. Such distortion diminishes the stature of PP.

Relatedly there is need to recognize the insularity of PP, much seeming United States-centric, particularly in leadership. By creating its own professional society and journal, PP unfortunately removed itself from the wider discipline of psychology and its subfields, each with their own organizations and journals. While new groups can nurture comradery and a sense of identity, they can also create distance from related areas of inquiry. Most problematic, they can lead to insider peer reviewing that likely lowers rather than elevates the quality of the work generated.

On the matter of the commercialization of PP, I am perhaps an outlier in seeing this as a significant problem. However, it is construed, those who care about the long-term future of PP need to grapple with how to prevent the pursuit of profit from becoming a force that could ultimately take the enterprise down – on grounds that it is not scientifically substantiated, nor is it properly regulated, or doing lasting good, or is even creating harm. Without proper oversight, business pursuits could become the antithesis of the original promise and purpose of PP – to advance optimal human functioning.

Most of my essay has not been about these troublesome matters. Rather, I have tried to underscore the widespread consensus, from within PP and beyond, that thoughtful formulations are needed going forward, which put positives and negative together – i.e., research and practice that integrates human strengths and vulnerabilities. Parenthetically, one benefit of this shift may be that the adjective “positive” is less relentlessly present in titles of articles, books, and journals. As many have observed, greater attention must be given to diversity – i.e., how the wide array of topics being studied vary by numerous dimensions (e.g., age, gender, race/ethnicity, socioeconomic status, disability status, sexual orientation, and cultural context). It is also critical that societal relevance be a priority in the future science and practice that lies ahead. So doing demands attending to contemporary problems, and how they are negotiated in diverse life contexts. Our societal ills further call for study of negatives that have historically been neglected (greed, indifference, stupidity, and anger). Nonetheless, amidst the contemporary turbulence is the promise of the arts and of nature to help us be better – in seeing and caring about the suffering of others as well as in inspiring us to make the most of the lives we have been given and do so with commitment that encompasses families, schools, the workplace, communities, and the planet.

Data Availability Statement

Publicly available datasets were analyzed in this study. This data can be found here: www.midus.wisc.edu .

Author Contributions

The author confirms being the sole contributor of this work and has approved it for publication.

National Institute on Aging Grants (P01-AG020166; U19-AG051426).

Conflict of Interest

The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

• ^ www.midus.wisc.edu
• ^ www.authentichappiness.org
• ^ www.theflourishingcenter.com

Allport, G. W. (1961). Pattern and Growth in Personality. Toronto: Holt.

Google Scholar

Arnold, M. (1867/1993). “Democracy,” in Culture and Anarchy and Other Writings , ed. S. Collini (Cambridge: Cambridge University Press), 1–25.

Balot, R. K. (2001). Greed and Injustice in Classical Athens. Princeton, NJ: Princeton University Press.

Beatty, P. (2015). The Sellout. London: Picador.

Boehm, J. K., Ruberton, P. M., and Lyubomirsky, S. (2021). “The promise of fostering greater happiness,” in Oxford Handbook of Positive Psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press), doi: 10.1093/oxfordhb/9780199396511.013.55

CrossRef Full Text | Google Scholar

Butler, J. (2011). Measuring Facets of Human Flourishing: Developing the Well-Being theory Questionnaire. Master’s thesis. Philadelphia: University of Pennsylvania.

Butler, J., and Kern, M. (2016). The PERMA-profiler: a brief multidimensional measure of flourishing. Int. J. Wellbeing 6, 1–48. doi: 10.5502/ijw.v6i3.526

PubMed Abstract | CrossRef Full Text | Google Scholar

Cameron, K., Dutton, J., and Quinn, R. (eds) (2003). Positive Organizational Scholarship: Foundations of a New Discipline. Oakland, CA: Berrett-Koehler Publishers, Inc.

Capaldi, C. A., Passmore, H. A., Nisbet, E. K., Zelenski, J. M., and Dopko, R. I. (2015). Flourishing in nature: a review of the benefits of connecting with nature and its application as a wellbeing intervention. Int. J. Wellbeing 5, 1–16. doi: 10.5502/ifw.v5i4.449

Carver, C. S., and Scheier, M. F. (1998). On the Self-Regulation of Behavior. Cambridge: Cambridge University Press. doi: 10.1017/CBO9781139174794

Carver, C. S., and Scheier, M. F. (2003). “Three human strengths,” in A Psychology of Human Strengths: Fundamental Questions and Future Directions for a Positive Psychology , eds L. G. Aspinwall and U. M. Staudinger (Washington, D.C: American Psychological Association), 87–102. doi: 10.1037/10566-007

Case, A., and Deaton, A. (2015). Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proc. Natl. Acad. Sci. 112, 15078–15083. doi: 10.1073/pnas.1518393112

Case, A., and Deaton, A. (2020). Deaths of Despair and the Future of Capitalism. Princeton, NJ: Princeton University Press.

Coan, R. W. (1977). Hero, Artist, Sage, or Saint? A Survey of Views on what is Variously Called Mental Health, Normality, Maturity, Self-Actualization, and Human Fulfillment. New York, NY: Columbia University Press.

Cohen, P. (2018). Paychecks Lag As Profits Soar, And Prices Erode Wage Gains. New York, NY: The New York Times.

Cutuli, J. J., Herbers, J. E., Masten, A. S., Reed, M.-G. J., Edwards, L. M., and Marques, S. C. (eds) (2021). “Resilience in development,” in Oxford Handbook of Positive Psychology , 3rd Edn, eds C. R. Snyder and S. J. Lopez (Oxford: Oxford University Press). doi: 10.1093/oxfordhb/9780199396511.013.9

Dante A. (1308/2006). The divine comedy. (H. W. Longfellow, Trans.). England: Chartwell Books

Delle Fava, A., and Negri, L. (2021). “Mental health: Multiple perspectives for an evolving concept,” in Oxford Handbook of Positive Psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press) doi: 10.1093/oxfordhb/9780199396511.013.6

Dickens, C. (1859/2004). A Tale of Two Cities. New York, NY: Barnes and Noble.

Duan, C., and Sager, K. (2021). “Understanding empathy: current state and future research challenges,” in Oxford Handbook of Positive Psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press). doi: 10.1093/oxfordhb/9780199396511.013.62

Edmundson, M. (2004). Why Read? New York, NY: Bloomsbury.

Edmundson, M. (2015). Self and Soul: A Defense of Ideals. Cambridge, MA: Harvard University Press.

Erikson, E. H. (1959). Identity and the life cycle: selected papers. Psychol. Issues 1, 1–171.

Fancourt, D. (2017). Arts in Health: Designing and Researching Interventions. Oxford: Oxford University Press. doi: 10.1093/oso/9780198792079.001.0001

Fancourt, D., and Finn, S. (2019). What is the Evidence on the Role of the Arts in Improving Health and Well-Being? A scoping Review (Health Evidence Network synthesis report 67). Denmark: WHO Regional Office for Europe.

Fava, G. A., Rafanelli, C., Cazzaro, M., Conti, S., and Grandi, S. (1998). Well-being therapy: a novel psychotherapeutic approach for residual symptoms of affective disorders. Psychol. Med. 28, 475–480. doi: 10.1017/s0033291797006363

Fredrickson, B. L. (1998). What good are positive emotions? Rev. Gen. Psychol. 2, 300–319.

Gable, S. L., and Maisel, N. (2021). “Positive processes in close relationships,” in Oxford Handbook of Positive Psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press). doi: 10.1093/oxfordhb/9780199396511.013.35

Giridharadas, A. (2018). Winners Take all: The Elite Charade Of Changing The World. New York, NY: Alfred A. Knopf.

Goldman, N., Glei, D. A., and Weinstein, M. (2018). Declining mental health among disadvantaged Americans. Proc. Natl. Acad. Sci. 115, 7290–7295. doi: 10.1073/pnas.1722023115

Goodman, F. R., Disabato, D. J., Kashdan, T. B., and Kauffman, S. B. (2018). Measuring well-being: a comparison of subjective well-being and PERMA. J. Positive Psychol. 13, 321–332. doi: 10.1080/17439760.2017.1388434

Gottman, J. (2001). “Meta-emotion, children’s emotional intelligence, and buffering children from marital conflict,” in Emotion, Social Relationships, and Health , eds C. D. Ryff and B. H. Singer (Oxford: Oxford University Press), 23–39. doi: 10.1093/acprof:oso/9780195145410.003.0002

Graham, E. K., Weston, S. J., Turiano, N. A., Aschwanden, D., Booth, T., Harrison, F., et al. (2020). Is healthy neuroticism associated with health behaviors? A coordinated integrative data analysis. Collabra. Psychol. 6:32. doi: 10.1525/collabra.266

Grant, B. F., Chou, S. P., Saha, T. D., Pickering, R. P., Kerridge, B. T., RUAN, W. J., et al. (2017). Prevalence of 12-month alcohol use, high-risk drinking, and DSM-IV alcohol use disorder in the United States, 2001-2002 to 2012-2013: Results from the national epidemiologic survey on alcohol and related conditions. JAMA Psychiatry 74, 911–923. doi: 10.1001/jamapsychiatry.2017.2161

Hamid, M. (2017). Exit West. New York, NY: Riverhead Books.

Harmon-Jones, C., Schmeichel, B., Mennitt, E., and Harmon-Jones, E. (2011). The expression of determination: similarities between anger and approach-related positive affect. J. Pers. Soc. Psychol. 100, 172–181. doi: 10.1037/a0020966

Heller, A. S., van Reekum, C. M., Schaefer, S. M., Lapate, R. C., Radler, B. T., Ryff, C. D., et al. (2013). Sustained ventral striatal activity predicts eduaimonic wel-being and cortisol output. Psychol. Sci. 24, 2191–2200. doi: 10.1177/0956797613490744

Helson, R., and Srivastava, S. (2001). Three paths of adult development: conservers, seekers, and achievers. J. Pers. Soc. Psychol. 80, 995–1010. doi: 10.1037/0022-3514.80.6.995

Henrich, J., Heine, S. J., and Norenzayan, A. (2010). The weirdest people in the world? Behav. Brain Sci. 33, 61–83. doi: 10.1017/S0140525X0999152X

Henry, C. S., Sheffield Morris, A., and Harrist, A. W. (2015). Family resilience: moving into the third wave. Fam. Relat. 64, 22–43. doi: 10.1111/fare.12106

Horowitz, D. (2018). Happier? The History Of A Cultural Movement That Aspired To Transform America. Oxford: Oxford University Press.

Hunter, J., Cross, M., and Pressman, S. (2021). “The associations between positive affect and health: Findings and future directions,” in Oxford Handbook of Positive Psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press), doi: 10.1093/oxfordhb/9780199396511.013.61

Iasiello, M., van Agteren, J., Keyes, C. L. M., and Cochrane, E. M. (2019). Positive mental health as a predictor of recovery from mental illness. J. Affect. Disord. 251, 227–230. doi: 10.1016/j.jad.2019.03.065

Jahoda, M. (1958). Current Concepts of Positive Mental Health. New York, NY: Basic Books.

James, W. (1902/1958). The Varieties Of Religious Experience. A study in Human Nature. (Gifford Lectures on Natural Religion, Edinburgh, 1901-1902.). New York, NY: New American Library.

Jung, C. G. (1933). Modern man in search of a soul (W. S. Dell & C. F. Baynes, Trans.). San Diego, CA: Harcourt, Brace & World.

Kasser, T., and Ryan, R. M. (1993). A dark side of the American dream: correlates of financial success as a central life aspiration. J. Pers. Soc. Psychol. 65, 410–422. doi: 10.1037/0022-3514.65.2.410

Kellert, S. R., and Wilson, E. O. (1993). The Biophilia Hypothesis. Washington, DC: Island Press.

Kern, M. L., Williams, P., Spong, C., Colla, R., Sharma, K., Downie, A., et al. (2020). Systems informed positive psychology. J. Posit. Psychol. 15, 705–715. doi: 10.1080/17439760.2019.1639799

Keyes, C. L. M. (2005). Mental illness and/or mental health? Investigating axioms of the complete state model of health. J. Consult. Clin. Psychol. 73, 539–548. doi: 10.1037/0022-006X.73.3.539

Keyes, C. L. M. (2007). Promoting and protecting mental health as flourishing. Am. Psychol. 62, 95–108. doi: 10.1037/0003-066X.62.2.95

Keyes, C. L. M. (2009). The Black-White paradox in health: flourishing in the face of social inequality and discrimination. J. Pers. 77, 1677–1706. doi: 10.1111/j.1467-6494.2009.00597.x

Keyes, C. L. M., Dhingra, S. S., and Simoes, E. J. (2010). Change in level of positive mental health as a predictor of future risk of mental illness. Am. J. Public Health 100, 2366–2371. doi: 10.2105/AJPH.2010.192245

King, L. A. (2001). The hard road to the good life: the happy, mature person. J. Hum. Psychol. 41, 51–72. doi: 10.1177/0022167801411005

Kirsch, J. A., Love, G. D., Radler, B. T., and Ryff, C. D. (2019). Scientific imperatives vis-à-vis growing inequality in America. Am. Psychol. 74, 764–777. doi: 10.1037/amp0000481

Kirsch, J. A., and Ryff, C. D. (2016). Hardships of the Great Recession and health: Understanding varieties of vulnerability. Health Psychology Open 3:2055102916652390. doi: 10.1177/2055102916652390

Kolodny, A., Courtwright, D. T., Hwang, C. S., Kreiner, P., Eadie, J. L., Clark, T. W., et al. (2015). The prescription opioid and heroin crisis: a public health approach to an epidemic of addiction. Annu. Rev. Public Health 36, 559–574. doi: 10.1146/annurev-publhealth-031914-122957

Kruger, A. B., and Posner, E. (2018). Corporate America is Suppressing Wages for Many Workers. New York, NY: The New York Times.

Larsen, J. T., Hemenover, S. H., Norris, C. J., and Cacioppo, J. T. (2003). “Turning adversity to advantage: on the virtues of the coactivation of positive and negative emotions,” in A psychology of human strengths: Fundamental questions and future directions for a positive psychology , eds L. G. Aspinwall and U. M. Staudinger (Washington, DC: American Psychological Association), 211–225. doi: 10.1037/10566-015

Lazarus, R. S. (2003). Target article: Does the positive psychology movement have legs? Psychol. Inq. 14, 93–109. doi: 10.1207/S15327965PLI1402_02

Lee, M. T., Kubzansky, L. D., and VanderWeele, T. J. (eds) (2021). Measuring Well-Being: Interdisciplinary Perspectives From The Social Sciences And Humanities. Oxford: Oxford University Press. doi: 10.1093/oso/9780197512531.001.0001

Loevinger, J. (1976). Ego development. Hoboken, NJ: Jossey-Bass.

Lomas, T., and Ivtzan, I. (2016). Second wave positive psychology: exploring the positive–negative dialectics of wellbeing. J. Happiness Stud. 17, 1753–1768. doi: 10.1007/s10902-015-9668-y

Lomas, T., Waters, L., Williams, P., Oades, L. G., and Kern, M. L. (2021). Third wave positive psychology: broadening towards complexity. J. Posit. Psychol. 16, 660–674. doi: 10.1080/17439760.2020.1805501

Luthar, S. S., Cicchetti, D., and Becker, B. (2000). The construct of resilience: a critical evaluation and guidelines for future work. Child Dev. 71, 543–562. doi: 10.1111/1467-8624.00164

Mantler, A., and Logan, A. C. (2015). Natural environments and mental health. Adv. Integr. Med. 2, 5–12. doi: 10.1016/j.aimed.2015.03.002

Marmion, J. F. (2018). The Psychology of Stupidity. New York, NY: Penguin Books.

Maslow, A. H. (1968). Toward a Psychology of Being , 2nd Edn. New York, NY: Van Nostrand.

McAdams, D. P., and St Aubin, E. (eds) (1998). Generativity and Adult Development: How and Why we Care for the Next Generation. Washington, DC: American Psychological Association.

McLendon, M. (2009). Rousseau, amour propre, and intellectual celebrity. J. Politics 71, 506–519. doi: 10.1017/S0022381609090422

McNulty, J. K., and Fincham, F. D. (2012). Beyond positive psychology? Toward a contextual view of psychological processes and well-being. Am. Psychol. 67, 101–110. doi: 10.1037/a0024572

Mendelberg, T., McCabe, K. T., and Thal, A. (2017). College socialization and the economic views of affluent Americans. Am. J. Political Sci. 61, 606–623. doi: 10.1111/ajps.12265

Mens, M. G., Scheier, M. F., and Carver, C. S. (2021). “Optimism,” in Oxford Handbook of Positive Psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press). doi: 10.1093/oxfordhb/9780199396511.013.24

Mikulincer, M., and Shaver, P. R. (2021). “Attachment theory as a relational framework for positive psychology,” in Oxford Handbook of Positive Psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press), doi: 10.1093/oxfordhb/9780199396511.013.63

Mill, J. S. (1893/1989). Autobiography. London: Penguin.

Miller, G. E., Lachman, M. E., Chen, E., Gruenewald, T. L., Karlamangla, A. S., and Seeman, T. E. (2011). Pathways to resilience: maternal nurturance as a buffer against the effects of childhood poverty on metabolic syndrome at midlife. Psychol. Sci. 22, 1591–1599. doi: 10.1177/0956797611419170

Mishra, P. (2017). Age of Anger: A History of the Present. New York, NY: Farrar, Straus, and Giroux.

Miyamoto, Y., and Ryff, C. D. (2011). Cultural differences in the dialectical and non-dialectical emotional styles and their implications for health. Cogn. Emot. 25, 22–39. doi: 10.1080/02699931003612114

Miyamoto, Y., and Ryff, C. D. (2021). Culture and health: recent developments and future directions. Jpn. Psychol. Res. [Online ahead of print] doi: 10.1111/jpr.12378

Moreno, P. I., Wiley, J. F., and Stanton, A. L. (2021). “Coping through emotional approach: The utility of processing and expressing emotions in response to stress,” in Oxford Handbook of Positive Psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press). doi: 10.1093/oxfordhb/9780199396511.013.19

Morozink, J. A., Friedman, C. M., Coe, C. L., and Ryff, C. D. (2010). Socioeconomic and psychosocial predictors of interleukin-6 in the MIDUS national sample. Health Psychol. 29, 629–635. doi: 10.1037/a0021360

Nakamura, J., and Chan, T. (2021). “Positive aging from a lifespan perspective,” in Oxford Handbook of Positive Psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press). doi: 10.1093/oxfordhb/9780199396511.013.12

Naragon-Gainey, K., and Watson, D. (2021). “Positive affectivity: The disposition to experience pleasurable emotional states,” in Oxford Handbook of Positive Psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press). doi: 10.1093/oxfordhb/9780199396511.013.17

Nikelly, A. (2006). The pathogenesis of greed: causes and consequences. Int. J. Appl. Psychoanal. Stud. 3, 65–78. doi: 10.1002/aps.50

Passmore, H.-A., and Howell, A. J. (2014). Nature involvement increases hedonic and eudaimonic well-being: a two-week experimental study. Ecopsychology 6, 148–154.

Pawelski, J. O. (2016). Defining the ‘positive’ in positive psychology: part I. A descriptive analysis. J. Posit. Psychol. 11, 339–356.

Pawelski, J. O., and Tay, L. (2021). “Better together: the sciences and the humanities in the quest for human flourishing,” in Oxford Handbook of Positive Psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press), doi: 10.1093/oxfordhb/9780199396511.013.67

Peck, M. S. (1983). People of the lie: The Hope for Healing Human Evil. New York, NY: Simon & Schuster.

Piff, P. K. (2013). Wealth and the inflated self: class, entitlement, and narcissism. Pers. Soc. Psychol. Bull. 40, 34–43. doi: 10.1177/0146167213501699

Piff, P. K., Stancato, D. M., Côté, S., Mendoza-Denton, R., and Keltner, D. (2012). Higher social class predicts increased unethical behavior. Proc. Natl. Acad. Sci. 109, 4086–4091. doi: 10.1073/pnas.1118373109

Purser, R. (2019). The Mindfulness Conspiracy. London: The Guardian.

Pury, C. L. S., Newlin, A. M. B., Burnett, E. A., and Lopez, S. J. (2021). “Courage,” in Oxford handbook of positive psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press), doi: 10.1093/oxfordhb/9780199396511.013.30

Rand, K. L., and Touza, K. K. (2021). “Hope theory,” in Oxford Handbook of Positive Psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press), doi: 10.1093/oxfordhb/9780199396511.013.25

Reis, H. T. (2001). “Relationship experiences and emotional well-being,” in Emotion, social relationships, and health , eds C. D. Ryff and B. H. Singer (Oxford: Oxford University Press), 57–86. doi: 10.1093/acprof:oso/9780195145410.003.0003

Reise, S. P. (2012). The rediscovery of bifactor measurement models. Multivar. Behav. Res. 47, 667–696. doi: 10.1080/00273171.2012.715555

Richardson, M., Passmore, H.-A., Barbett, L., Lumber, R., Thomas, R., and Hunt, A. (2020). The green care code: how nature connectedness and simply activities help explain pro-nature conservation behaviors. People Nat. 2, 821–839. doi: 10.1002/pan3.10117

Rogers, C. R. (1961). On Becoming a Person. Boston, MA: Houghton Mifflin.

Ruini, C. (2017). Positive Psychology in the Clinical Domains: Research And Practice. New York, NY: Springer International.

Ruini, C., and Fava, G. A. (2009). Well-being therapy for generalized anxiety disorder. J. Clin. Psychol. 65, 510–519. doi: 10.1002/jclp.20592

Ruini, C., and Marques, S. C. (2021). “Psychotherapy, counseling, and coaching: Different alternatives for promoting psychological well-being,” in Oxford Handbook of Positive Psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press), doi: 10.1093/oxfordhb/9780199396511.013.49

Rusk, R. D., and Waters, L. E. (2013). Tracing the size, reach, impact, and breadth of positive psychology. J. Posit. Psychol. 8, 207–221. doi: 10.1080/17439760.2013.7777.66

Ryan, J., Curtis, R., Olds, T., Edney, S., Vandelanotte, C., Plotnikoff, R., et al. (2019). Psychometric properties of the PERMA profiler for measuring wellbeing in Australian adults. PLoS One 14:e0225932. doi: 10.1371/journal.pone.0225932

Ryan, R. M., and Deci, E. L. (2001). On happiness and human potentials: a review of research on hedonic and eudaimonic well-being. Annu. Rev. Psychol. 52, 141–166. doi: 10.1146/annurev.psych.52.1.141

Ryff, C., Friedman, E., Fuller-Rowell, T., Love, G., Miyamoto, Y., Morozink, J., et al. (2012). Varieties of resilience in MIDUS. Soc. Pers. Psychol. Compass 6, 792–806. doi: 10.1111/j.1751-9004.2012.00462.x

Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. J. Pers. Soc. Psychol. 57, 1069–1081. doi: 10.1037/0022-3514.57.6.1069

Ryff, C. D. (2003). Corners of myopia in the positive psychology parade. Psychol. Inq. 14, 153–159.

Ryff, C. D. (2012). “Contradiction at the core of the positive psychology movement: The essential role of the negative in adaptive human functioning,” in Proceedings of the 6th European Conference on Positive Psychology , (Moscow: Russian Federation).

Ryff, C. D. (2014). Psychological well-being revisited: advances in the science and practice of eudaimonia. Psychother. Psychosomat. 83, 10–28. doi: 10.1159/000353263

Ryff, C. D. (2017). Eudaimonic well-being, inequality, and health: recent findings and future directions. Int. Rev. Econ. 64, 159–178. https://doi.10.1007/s12232-017-0277-4 , doi: 10.1007/s12232-017-0277-4

Ryff, C. D. (2018). Well-being with soul: Science in pursuit of human potential. Perspect. Psychol. Sci. 13, 242–248. doi: 10.1177/1745691617699836

Ryff, C. D. (2019). Linking Education in the Arts and Humanities to Life-Long well-Being and Health. New York, NY: Andrew W. Mellon Foundation

Ryff, C. D. (2021a). “Well-being in turbulent times: Suffering, stupidity, indifference, and Walt Whitman,” in Proceedings of the Plenary Address, 7th International Conference of the International Positive Psychology Association (virtual). (Vancouver: IPPA)

Ryff, C. D. (2021b). Spirituality and well-being: theory, science, and the nature connection. Religions 12:914. doi: 10.3390/rel12110914

Ryff, C. D. (2022). “Reflections on an improbably journey,” in Reflections from pioneering women in psychology , eds J. Bookwala and N. J. Newton (Cambridge: Cambridge University Press).

Ryff, C. D., Boylan, J. M., and Kirsch, J. A. (2021a). “Advancing the science of well-being: A dissenting view of measurement recommendations,” in Measuring well-being: Interdisciplinary Perspectives from the Social Sciences and Humanities , eds M. T. Lee, L. D. Kubzansky, and T. J. VanderWeele (Oxford: Oxford University Press), doi: 10.1093/oso/9780197512531.003.0019

Ryff, C. D., Boylan, J. M., and Kirsch, J. A. (2021b). “Response to response: Growing the field of well-being,” in Measuring well-being: Interdisciplinary Perspectives from the Social Sciences and humanities , eds M. T. Lee, L. D. Kubzansky, and T. J. VanderWeele (Oxford: Oxford University Press), doi: 10.1093/oso/9780197512531.003.0021

Ryff, C. D., Boylan, J. M., and Kirsch, J. A. (2021c). “Eudaimonic and hedonic well-being: An integrative perspective with linkages to sociodemographic factors and health,” in Measuring well-being: Interdisciplinary Perspectives from the Social Sciences and Humanities , eds M. T. Lee, L. D. Kubzansky, and T. J. VanderWeele (Oxford: Oxford University Press), doi: 10.1093/oso/9780197512531.003.0005

Ryff, C. D., and Kim, E. S. (2020). “Extending research linking purpose in life to health: the challenges of inequality, the potential of the arts, and the imperative of virtue,” in The Ecology of Purposeful Living across the Lifespan , eds A. L. Burrow and P. Hill (Berlin: Springer), 29–58. doi: 10.1007/978-3-030-52078-6_3

Ryff, C. D. (forthcoming). Meaning-making in the face of intersecting catastrophes: COVID-19 and the plague of inequality. J. Constructivist Psychol.

Salomon, C. (2017). Charlotte Salomon: Life? Or theatre?. London: Overlook Duckworth.

Schuchat, A., Houry, D., and Guy, G. P. Jr. (2017). New data on opioid use and prescribing in the United States. JAMA 318, 425–426. doi: 10.1001/jama.2017.8913

Seligman, M. E. P. (1999). The president’s address. Am. Psychol. 53, 559–562.

PubMed Abstract | Google Scholar

Seligman, M. E. P. (2002). Authentic Happiness: Using the New Positive Psychology to Realize your Potential for Lasting Fulfillment. Mumbai: Free Press.

Seligman, M. E. P. (2011). Flourish: A Visionary new Understanding of Happiness and Well-being. Mumbai: Free Press.

Seligman, M. E. P. (2018). PERMA and the building blocks of well-being. J. Positive Psychol. 13, 333–335. doi: 10.1080/17439760.2018.1437466

Seligman, M. E. P. (2019). Positive psychology: a personal history. Annu. Rev. Clin. Psychol. 15, 3–23. doi: 10.1146/annurev-clinpsy-050718-095653

Seligman, M. E. P., and Csikszentmihalyi, M. (2000). Positive psychology: an introduction. Am. Psychol. 55, 5–14. doi: 10.1037/0003-066X.55.1.5

Seligman, M. E. P., Steen, T. A., Park, N., and Peterson, C. (2005). Positive psychology progress: empirical validations of interventions. Am. Psychol. 60, 410–421. doi: 10.1037/0003-066X.60.5.410

Shanahan, M. J., Hill, P. L., Roberts, B. W., Eccles, J., and Friedman, H. (2014). Conscientiousness, health, and aging: the life course personality model. Dev. Psychol. 50, 1407–1425. doi: 10.1037/a0031130

Sheridan, S. M., Warnes, E. D., Cowan, R. J., Schemm, A. V., and Clarke, B. L. (2004). Family-centered positive psychology: Focusing on strengths to build student success. Psychol. Schools 41, 7–17. doi: 10.1002/pits.10134

Silvia, P. J., and Kashdan, T. B. (2021). “Curiosity and interest: The benefits of thriving on novelty and challenge,” in Oxford Handbook of Positive Psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press), doi: 10.1093/oxfordhb/9780199396511.013.29

Smith, A. (1776/1981). An Inquiry into the Nature and Causes of the Wealth of Nations. Carmel: Liberty Classics.

Snyder, C. R., Lopez, S. J., Edwards, L. M., and Marques, S. C. (eds) (2021). Oxford Handbook of Positive Psychology , 3rd Edn. Oxford: Oxford University Press, doi: 10.1093/oxfordhb/9780199396511.001.0001

Steger, M. F. (2021). “Meaning in life: A unified model,” in Oxford handbook of positive psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press).

Stewart, M. (2021). The 9.9 percent: The new Aristocracy that is Entrenching Inequality and Warping our Culture. New York, NY: Simon & Schuster.

Stout, M. (2006). The Sociopath Next Door. New York, NY: Harmony.

Swift, J. (1729). A Modest Proposal. North Carolina: Project Gutenberg.

Tarragona, M. (2021). “Personal narratives, expressive writing and wellbeing,” in Oxford handbook of positive psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press), doi: 10.1093/oxfordhb/9780199396511.013.52

Tedeschi, R. G., Park, C. L., and Calhoun, L. G. (eds) (1998). The lea series in personality and clinical psychology. Posttraumatic growth: positive changes in the aftermath of crisis. New York, NY: Lawrence Erlbaum Associates.

Triguero-Mas, M., Dadvand, P., Cirach, M., Martinez, D., Medina, A., Mompart, A., et al. (2015). Natural outdoor environments and mental and physical health: relationships and mechanisms. Environ. Int. 77, 35–41. doi: 10.1016/j.envint.2015.01.012

Tsang, J.-A., and Martin, S. R. (2021). “Forgiveness,” in Oxford Handbook of Positive Psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press), doi: 10.1093/oxfordhb/9780199396511.013.32

Tugade, M., Devlin, H. C., and Frederickson, B. L. (2021). “Positive emotions,” in Oxford Handbook of Positive Psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press), doi: 10.1093/oxfordhb/9780199396511.013.1

Ulrich, R. S., Simons, R. F., Losito, B. D., Fiorito, E., Miles, M. A., and Zelson, M. (1991). Stress recovery during exposure to natural and urban environments. J. Environ. Psychol. 11, 201–230. doi: 10.1016/s0272-4944(05)80184-7

Umucu, E., Wu, J.-R., Sanchez, J., Brooks, J. M., Chiu, C.-Y., Tu, W.-M., et al. (2020). Psychometric validation of the PERMA-profiler as a well-being measure for student veterans. J. Am. College Health 68, 271–277. doi: 10.1080/07448481.2018.1546182

Van der Vliet Oloomi, A. (2018). Call me zebra. Boston, MA: Houghton Mifflin Harcourt.

van Zyl, L. E. (2022). Grand challenges for positive psychology: contemporary critiques and criticisms. Front. Psychol.

van Zyl, L. E., Schotanus-Dijkstra, M., Llorens, S., Klibert, J., van den Heuvel, M., and Mayer, C.-H. (2021). Call for papers: positive psychological interventions beyond WEIRD contexts: How, when, and why they work. Front. Psychol.

VanderWeele, T. J., Trudel-Fitzgerald, C., Allin, P. V., Farrelly, C., Fletcher, G., Frederick, D. E., et al. (2021a). “Current recommendations on the selection of measures for well-being,” in Measuring well-being: Interdisciplinary perspectives from the social sciences and humanities , eds M. T. Lee, L. D. Kubzansky, and T. J. VanderWeele (Oxford: Oxford University Press), doi: 10.1093/oso/9780197512531.003.0018

VanderWeele, T. J., Trudel-Fitzgerald, C., and Kubzansky, L. (2021b). “Response to “advancing the science of well-being: A dissenting view on measurement recommendations,” in Measuring well-being: Interdisciplinary perspectives from the social sciences and humanities , eds M. T. Lee, L. D. Kubzansky, and T. J. VanderWeele (Oxford: Oxford University Press), doi: 10.1093/oso/9780197512531.003.0020

Vazquez, C., Valiente, C., García, F. E., Contreras, A., Peinado, V., Trucharte, A., et al. (2020). Post-traumatic growth and stress-related responses during the COVID-19 pandemic in a national representative sample: the role of core beliefs about the world and others. J. Happiness Stud. 22, 2915–2935. doi: 10.1007/s10902-020-00352-3

Veenhoven, R. (2021). “Happiness in nations: Pursuit of greater happiness for a greater number of citizens,” in Oxford handbook of positive psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press), doi: 10.1093/oxfordhb/9780199396511.013.15

Von Franz, M. L. (1964). “The process of individuation,” in Man and his Symbols , ed. C. G. Jung (New York, NY: Doubleday), 158–229.

Wammerl, M., Jaunig, J., Mairunteregger, T., and Streit, P. (2019). The German version of the PERMA-profiler: evidence for construct and convergent validity of the PERMA theory of well-being in German speaking countries. J. Well Being Assess. 3, 75–96. doi: 10.1007/s41543-019-00021-0

Watanabe, K., Kawakami, N., Shiotani, T., Adachi, H., Matsumoto, K., Imamura, K., et al. (2018). The Japanese workplace PERMA-profiler: a validation study among Japanese workers. J. Occup. Health 60, 383–393. doi: 10.1539/joh.2018-0050-OA

Waters, L., Algoe, S. B., Dutton, J., Emmons, R., Fredrickson, B. L., Heaphy, E., et al. (2021). Positive psychology in a pandemic: buffering, bolstering, and building mental health. J. Posit. Psychol. doi: 10.1080/17439760.2021.1871945

Waters, S., Cross, D., and Shaw, T. (2010). Does the nature of schools matter? An exploration of selected school ecology factors on adolescent perceptions of school connectedness. Br. J. Educ. Psychol. 80, 381–402. doi: 10.1348/000709909X484479

Wong, P. T. P. (2011). Positive psychology 2.0: Towards a balanced interactive model of the good life. Can. Psychol. 52, 69–81. doi: 10.1037/a0022511

Wong, P. T. P., and Fry, P. S. (eds) (1998). The Human Quest For Meaning: A Handbook of Psychological Research and Clinical Applications. New York, NY: Lawrence Erlbaum Associates, Inc.

Worth, P. (ed.) (2022). Positive psychology across the life span: An existential perspective. Oxfordshire: Routledge.

Worthington, E. L., Goldstein, L., Hammock, B., Griffin, B. J., Garthe, R. C., Lavelock, C., et al. (2021). “Humility: A qualitative review,” in Oxford handbook of positive psychology , 3rd Edn, eds C. R. Snyder, S. J. Lopez, L. M. Edwards, and S. C. Marques (Oxford: Oxford University Press), doi: 10.1093/oxfordhb/9780199396511.013.3

Wulf, A. (2016). The Invention of Nature: Alexander von Humboldt’s New World. New York, NY: Penguin Random House.

Yalom, I. D. (1980). Existential Psychotherapy. New York, NY: Basic Books.

Keywords : positive, negative, commercialization, inequality, greed, indifference, arts, nature

Citation: Ryff CD (2022) Positive Psychology: Looking Back and Looking Forward. Front. Psychol. 13:840062. doi: 10.3389/fpsyg.2022.840062

Received: 20 December 2021; Accepted: 21 February 2022; Published: 17 March 2022.

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*Correspondence: Carol D. Ryff, [email protected]

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